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<p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective pharmacological treatments for obesity, through appetite suppression and weight reduction. However, their potential influence on physical activity (PA), a key determinant of long-term energy balance, remains unclear. This review aimed to evaluate whether GLP-1 RA treatment affects objectively measured PA in adults with overweight or obesity. A systematic review and exploratory meta-analysis were conducted in accordance with PRISMA guidelines. PubMed and Embase were searched from inception to March 10, 2026. Eligible studies included randomized and non-randomized controlled trials examining objectively measured PA outcomes (e.g., step counts, sedentary time, and intensity-specific PA). Narrative synthesis was performed across all studies, and a random-effects meta-analysis was conducted for studies reporting comparable free-living PA outcomes. Seven studies from six independent trials (<i>n</i> = 924) were included. Most studies reported no statistically significant differences in PA between GLP-1 RA and control groups. However, five studies (71.4%) showed numerically lower free-living PA in GLP-1 RA-treated groups, with one study reporting a significant reduction in daily step counts (–1144 steps/day, <i>p</i> = 0.01). Structured exercise-related outcomes, including adherence and prescribed exercise duration, were comparable between groups. Meta-analysis of three RCTs showed no significant pooled effect (Hedges’ g = –0.11, 95% CI –0.30 to 0.09, I<sup>2</sup> = 0.0%). Sensitivity analyses suggested a modest reduction in PA (Hedges’ g = –0.24, 95% CI –0.46 to –0.02, <i>p</i> = 0.035, I<sup>2</sup> = 34.3%), influenced by study design and outcome heterogeneity. GLP-1 RA treatment does not significantly alter overall PA but may be associated with a small reduction in free-living PA, while structured exercise participation remains unaffected. These findings suggest a potential influence on spontaneous, non-obligatory activity rather than exercise capacity. Further studies using standardized objective PA measures are needed.</p>

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The impact of glucagon-like peptide-1 receptor agonists on objective physical activity in adults: a systematic review and exploratory meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Heeyeon Kim,
  • Ji Heon Chae,
  • Hyo Youl Moon

摘要

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective pharmacological treatments for obesity, through appetite suppression and weight reduction. However, their potential influence on physical activity (PA), a key determinant of long-term energy balance, remains unclear. This review aimed to evaluate whether GLP-1 RA treatment affects objectively measured PA in adults with overweight or obesity. A systematic review and exploratory meta-analysis were conducted in accordance with PRISMA guidelines. PubMed and Embase were searched from inception to March 10, 2026. Eligible studies included randomized and non-randomized controlled trials examining objectively measured PA outcomes (e.g., step counts, sedentary time, and intensity-specific PA). Narrative synthesis was performed across all studies, and a random-effects meta-analysis was conducted for studies reporting comparable free-living PA outcomes. Seven studies from six independent trials (n = 924) were included. Most studies reported no statistically significant differences in PA between GLP-1 RA and control groups. However, five studies (71.4%) showed numerically lower free-living PA in GLP-1 RA-treated groups, with one study reporting a significant reduction in daily step counts (–1144 steps/day, p = 0.01). Structured exercise-related outcomes, including adherence and prescribed exercise duration, were comparable between groups. Meta-analysis of three RCTs showed no significant pooled effect (Hedges’ g = –0.11, 95% CI –0.30 to 0.09, I2 = 0.0%). Sensitivity analyses suggested a modest reduction in PA (Hedges’ g = –0.24, 95% CI –0.46 to –0.02, p = 0.035, I2 = 34.3%), influenced by study design and outcome heterogeneity. GLP-1 RA treatment does not significantly alter overall PA but may be associated with a small reduction in free-living PA, while structured exercise participation remains unaffected. These findings suggest a potential influence on spontaneous, non-obligatory activity rather than exercise capacity. Further studies using standardized objective PA measures are needed.