Want to lose weight? Here’s why exercise probably won’t help

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I exercise most days, but the number on the scale never moves. What’s even the point?

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Exercise is not very effective for weight loss, but it’s incredibly beneficial for your physical and mental health.

As a sports medicine physician, I spend my days treating injuries, studying human performance and helping my patients move. I prescribe exercise for health and believe deeply in its power. The evidence is overwhelming: Exercise lowers cardiovascular risk, improves blood sugar control, strengthens bones, preserves cognitive function and reduces the risk of depression, cancer and early death.

But there is one area where exercise consistently falls short: weight loss.

A patient in her 50s recently came to me frustrated. She walked most days, strength trained twice a week and followed a careful diet. Yet her weight barely budged. She asked me a question that I often hear: “What is the point of exercise if the scale doesn’t move?”

The irony was that almost everything important about her health was improving. The problem was that she had been conditioned to focus on the wrong number.

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Why exercise doesn’t work for weight loss

In a culture that treats the gym as a calorie-burning machine, many people expect exercise to shrink their waistline. When it doesn’t, frustration follows. The truth is that our expectations are misguided. Large studies show that exercise alone usually produces modest weight loss, often just a few pounds over six months. That’s because your body will “correct” for the extra activity by increasing your appetite or by lowering the calories burned for other bodily functions.

In a 2024 randomized trial involving middle-aged adults who were overweight, participants assigned to regular exercise without changing their diet improved fitness and metabolic markers but lost little weight.

As we age, the challenge grows. Resting metabolism slows and the body becomes more efficient at conserving energy. Various factors influence this, including age-related sarcopenia, or muscle loss with aging. We have to exercise for longer or more intensely – to the point it may become unrealistic – to achieve a calorie deficit substantial enough for weight loss.

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That does not mean exercise fails. It succeeds brilliantly. We have simply been asking it to do the wrong job.

Proven health benefits of exercise

Exercise shines when it comes to metabolic health. It improves insulin sensitivity and reduces visceral fat, the type of body fat that lies deep in the abdomen and is linked to heart disease and Type 2 diabetes. These benefits often occur even when body weight stays the same. Recent research shows that short bursts of movement built into daily life, “exercise snacks,” lead to significant reductions in disease risk, even in small doses.

Exercise makes people healthier even when it does not make them thinner. In fact, people who are fit tend to live longer than those who are not in shape, no matter what their body weights are.

This distinction is important in the age of GLP-1 medications and other weight loss drugs. For many, these treatments make losing weight easier than ever. They have changed the weight-loss equation for thousands of my patients. But weight loss alone is not health.

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Rapid, medication-driven weight loss can carry hidden costs, including loss of muscle. Muscle is central to mobility, glucose control and healthy longevity. Losing muscle while getting lighter may improve the scale but leaves people less resilient.

That is why my advice often surprises patients. I would rather see someone mildly overweight and physically active than thin and inactive. The former usually has better fitness, stronger bones, more muscle and greater protection against disease. The latter may look healthy but often carries hidden risks.

If the goal is long-term health, prioritize movement and muscle, not weight alone. Walk more. Lift weights. Climb stairs. Carry groceries. Build strength into daily life. Use exercise as a tool for healthy longevity, not as a stand-alone vehicle for weight loss.

For decades, we have equated thinness with health. It is time to change that. Consistent movement may or may not change your weight, but it always improves health. That is the outcome that truly matters.

Jordan D. Metzl, MD, is a sports medicine physician at Hospital for Special Surgery in New York. His newest book, “PUSH: Unlock the Science of Fitness Motivation to Embrace Health and Longevity,” explores the topics of fitness motivation and muscle maintenance for healthy longevity.

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