The effects of weight‐lowering pharmacotherapies on physical activity, function and fitness: A systematic review and meta‐analysis of randomized controlled trials
Open accessAbstract
Summary: Weight‐lowering pharmacotherapies provide an option for weight management; however, their effects on physical activity, function, and cardiorespiratory fitness are not fully understood. We conducted a systematic review and meta‐analysis of randomized controlled trials to investigate the effect of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. Fourteen trials met our prespecified inclusion criteria: Five investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate. All 14 trials included a self‐reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short‐Form 36‐Item Questionnaire (SF‐36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life‐Lite (IWQOL‐Lite) (0.29; 0.23 to 0.35). Meta‐regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL‐Lite (p = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self‐reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined.
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Few data have been published from the STEP and SURMOUNT trials on potential changes in participants' physical activity or cardiorespiratory fitness occurring with weight loss, an absence also detected by a recent meta-analysis.
“As with dietary-intake findings, few data have been published from these trials on potential changes in participants’ physical activity or cardiorespiratory fitness occurring with weight loss, an absence also detected by a recent meta-analysis of the literature [93].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [93]
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- Authors
- Jobanputra, R., Sargeant, J. A., Almaqhawi, A., Ahmad, E., Arsenyadis, F., Webb, D. R., Herring, L. Y., Khunti, K., Davies, M. J., & Yates, T.
- Affiliations
- University of Leicester (GB)
- Corresponding author
- Jobanputra, Rishi
- ORCID
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2023-01-31
- Volume
- 24
- Issue
- 4
- Pages
- e13553-e13553
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W4318755414
- Cited by
- 22
- References
- 37
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 6 · 2023: 2
- FWCI
- 0.79
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Obesity Reviews (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (NIHR-INF-1279)
- NIHR Leicester Biomedical Research Centre
- NIHR Leicester Clinical Research Facility
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, physical function, physical activity, cardiorespiratory fitness, liraglutide, semaglutide, naltrexone/bupropion, phentermine/topiramate, quality of life, weight loss
- MeSH terms
- Humans, Obesity, Physical Fitness, Quality of Life, Weight Loss, Exercise, Randomized Controlled Trials as Topic
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