Physical Fitness with Exercise and GLP-1 Receptor Agonist Treatment Alone or Combined After Diet-Induced Weight Loss: A Secondary Analysis of a Randomized Controlled Trial in Adults with Obesity.

Jensen SBK, Fiorenza M, Juhl CR, Sandsdal RM, Jensen E, Seier SS, Janus C, Jørgensen JR, Blond MB, Holst JJ, Stallknecht BM, Madsbad S, Bandholm T, Torekov SS

Sports medicine (Auckland, N.Z.)24 Jan 2026Cited by 9 (Europe PMC)

PMID41579235PMCIDPMC13388483DOI10.1007/s40279-025-02386-0PepBankPUB-41579235

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Summary

BackgroundObesity is associated with impaired physical fitness, including physical functional performance and cardiorespiratory fitness, which affect health-related quality of life and mortality.ObjectiveWe aimed to investigate the efficacy of a moderate-to-vigorous intensity exercise program and glucagon-like peptide-1 receptor agonist treatment alone or in combination during weight maintenance for physical fitness.MethodsThis is secondary analysis of a randomized controlled trial involving 193 adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity. The exercise program was a combination of group sessions (interval-based indoor cycling followed by circuit training) and individual sessions of moderate-to-vigorous intensity, designed to meet the World Health Organization recommendations on physical activity for health. Exercise adherence was measured with sports watches and heart rate monitors. Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).ResultsParticipants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide. Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5]. Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness. Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.ConclusionsStructured exercise combined with glucagon-like peptide-1-based obesity pharmacotherapy led to clinically meaningful improvements in physical functional performance and cardiorespiratory fitness, in contrast to pharmacotherapy alone.Clinical trial registrationEudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study11

5 results from studies that gave the peptide. 5 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with obesity without diabetes, liraglutide alone did not improve physical fitness.
In plain wordsIn adults with obesity without diabetes, liraglutide alone did not improve physical fitness.
Peptide
Liraglutide
Outcome
Not applicablePhysical fitness
Study
n: not reported in source
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Studied dose
3 mg once-daily · 52 weeksAs given in this study (human).
Source sentences
Summary
Exercise alone led to similar benefits, whereas liraglutide alone did not improve physical fitness.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
Show in the study text Report a problemFND-4157923503
02HumanRandomized controlled trialEfficacy outcome
In adults with obesity without diabetes, relative muscle strength was higher with liraglutide than placebo, with lower weight and preserved absolute strength.
In plain wordsIn adults with obesity without diabetes, relative muscle strength was higher with liraglutide than placebo, with lower weight and preserved absolute strength.
Peptide
Liraglutide
Outcome
IncreaseRelative muscle strength
Study
n: not reported in source
Comparator
Placebo
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Studied dose
3 mg once-daily · 52 weeksAs given in this study (human).
Measurements
Relative muscle strength change
1%
liraglutide
Relative muscle strength change
−7.8%
placebo
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
Show in the study text Report a problemFND-4157923504
03HumanRandomized controlled trialEfficacy outcome
In adults with obesity without diabetes, preserved absolute strength was reported alongside higher relative muscle strength with liraglutide.
In plain wordsIn adults with obesity without diabetes, absolute muscle strength was preserved with liraglutide.
Peptide
Liraglutide
Outcome
Not applicableAbsolute muscle strength preservation
Study
n: not reported in source
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Studied dose
3 mg once-daily · 52 weeksAs given in this study (human).
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
Show in the study text Report a problemFND-4157923507
04HumanRandomized controlled trialEfficacy outcome
Among adults aged 18-65 years with obesity without diabetes assigned exercise, there was no significant difference in exercise adherence between liraglutide 3 mg once daily and placebo over 52 weeks.
In plain wordsAmong adults with obesity without diabetes assigned exercise, exercise adherence did not differ significantly between liraglutide and placebo.
Peptide
Liraglutide
Outcome
No significant changeExercise adherence
Study
n: not reported in source
Comparator
Placebo
Outcome group
Exercise and physical function · Musculoskeletal
Studied dose
3 mg once-daily · 52 weeksAs given in this study (human).
Source sentences
Summary
Participants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
Show in the study text Report a problemFND-4157923506
05HumanRandomized controlled trialMechanism
In adults with obesity without diabetes, lower weight was reported as an explanation for higher relative muscle strength with liraglutide.
In plain wordsIn adults with obesity without diabetes, lower weight helped explain higher relative muscle strength with liraglutide.
Peptide
Liraglutide
Outcome
DecreaseLower body weight underlying relative muscle strength
Study
n: not reported in source
Outcome group
Body weight · Metabolic and weight
Studied dose
3 mg once-daily · 52 weeksAs given in this study (human).
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
Show in the study text Report a problemFND-4157923509

Studies that did not test the peptide alone6

In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Liraglutide.

06HumanNot a test of Liraglutide aloneRandomized controlled trialEfficacy outcome
In adults aged 18-65 years with obesity without diabetes, exercise plus liraglutide reduced stair-climb completion time by 1.2 s (8.6%) versus liraglutide alone.
In plain wordsIn adults with obesity without diabetes, exercise plus liraglutide reduced stair-climb time more than liraglutide alone.
Peptide
Liraglutide
Outcome
DecreaseStair climb test time
Study
n: not reported in source
Comparator
Liraglutide alone
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Measurements
Stair climb time reduction
1.2 s
combined treatment versus liraglutide alone; 95% CI 0.6-1.9
Stair climb time reduction
8.6%
combined treatment versus liraglutide alone
Source sentences
Summary
Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5].
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923501
07HumanNot a test of Liraglutide aloneRandomized controlled trialEfficacy outcome
In adults aged 18-65 years with obesity without diabetes, exercise plus liraglutide improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass versus liraglutide alone.
In plain wordsIn adults with obesity without diabetes, exercise plus liraglutide improved peak oxygen use more than liraglutide alone.
Peptide
Liraglutide
Outcome
IncreasePeak oxygen consumption
Study
n: not reported in source
Comparator
Liraglutide alone
Analysis
Secondary
Outcome group
Exercise and physical function · Cardiovascular
Measurements
Peak oxygen consumption change
3 mL/min/kg fat-free mass
combined treatment versus liraglutide alone
Source sentences
Summary
Compared with liraglutide alone, the combined treatment decreased time to complete a stair climb test by 1.2 s [95% confidence interval 0.6-1.9] (corresponding to 8.6%) and improved peak oxygen consumption by 3.0 mL/min/kg fat-free mass [95% confidence interval 0.5-5.5].
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923502
08HumanNot a test of Liraglutide aloneRandomized controlled trialEfficacy outcome
In adults with obesity without diabetes, relative muscle strength was higher with exercise plus liraglutide than placebo, with lower weight and preserved absolute strength.
In plain wordsIn adults with obesity without diabetes, relative muscle strength was higher with exercise plus liraglutide than placebo, alongside lower weight and preserved absolute strength.
Peptide
Liraglutide
Outcome
IncreaseRelative muscle strength
Study
n: not reported in source
Comparator
Placebo
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Measurements
Relative muscle strength change
3.3%
combined treatment
Relative muscle strength change
−7.8%
placebo
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923505
09HumanNot a test of Liraglutide aloneRandomized controlled trialEfficacy outcome
In adults with obesity without diabetes, preserved absolute strength was reported alongside higher relative muscle strength with exercise plus liraglutide.
In plain wordsIn adults with obesity without diabetes, absolute muscle strength was preserved with exercise plus liraglutide.
Peptide
Liraglutide
Outcome
Not applicableAbsolute muscle strength preservation
Study
n: not reported in source
Analysis
Secondary
Outcome group
Exercise and physical function · Musculoskeletal
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923508
10HumanNot a test of Liraglutide aloneRandomized controlled trialMechanism
In adults with obesity without diabetes, lower weight was reported as an explanation for higher relative muscle strength with exercise plus liraglutide.
In plain wordsIn adults with obesity without diabetes, lower weight helped explain higher relative muscle strength with exercise plus liraglutide.
Peptide
Liraglutide
Outcome
DecreaseLower body weight underlying relative muscle strength
Study
n: not reported in source
Outcome group
Body weight · Metabolic and weight
Source sentences
Summary
Compared with placebo (- 7.8%), relative muscle strength (strength normalized to body weight) was higher with exercise (- 0.4%), liraglutide (+ 1.0%), and the combined treatment (+ 3.3%) because of lower weight and preserved absolute strength.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Key secondary endpoints related to physical fitness were changes from randomization to the end of treatment (weeks 0-52) in: (1) physical functional performance (time to ascend and descend an 11-step stairway twice); (2) cardiorespiratory fitness (peak oxygen consumption normalized to fat-free mass); and (3) muscle strength (isometric knee extensor peak torque).
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923510
11HumanNot a test of Liraglutide aloneRandomized controlled trialOther
In adults with obesity without diabetes, the pooled exercise-plus-placebo and exercise-plus-liraglutide groups performed a median 2.65 exercise sessions per week (116 min/week at 79% maximum heart rate).
In plain wordsIn adults with obesity without diabetes, pooled exercise-plus-placebo and exercise-plus-liraglutide groups performed a median 2.65 exercise sessions weekly.
Peptide
Liraglutide
Outcome
Not applicableExercise adherence in pooled exercise arms
Study
n: not reported in source
Outcome group
Exercise and physical function · Musculoskeletal
Measurements
Median exercise sessions
2.65 sessions/week
pooled exercise arms
Exercise duration
116 min/week
pooled exercise arms
Exercise intensity
79 % maximum heart rate
pooled exercise arms
Source sentences
Summary
Participants randomized to exercise performed a median 2.65 session/week (116 min/week at 79% of maximum heart rate) with no significant difference between those who received placebo or liraglutide.
2 context sentences(design, population, supporting numbers)
Summary · context
adults with obesity (age 18-65 years, body mass index 32-43 kg/m²) without diabetes mellitus who completed an 8-week low-calorie diet and were subsequently randomized (1:1:1:1 ratio) to: exercise plus placebo; glucagon-like peptide-1 receptor agonist liraglutide 3 mg once-daily plus usual activity; exercise plus liraglutide combined; or placebo plus usual activity.
Summary · context
Exercise adherence was measured with sports watches and heart rate monitors.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-4157923511

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials1

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

1 trial · source ClinicalTrials.gov (opens in a new tab)

Status unknownPhase 4NCT04122716

Combined Effects of GLP-1 Analogue and Exercise on Maintenance of Weight Loss and Health After Very-low Calorie Diet

Signe Torekovn = 215Sept 2016 to est. Nov 2021

Obesity

Trial page ClinicalTrials.govUpdated 2 Nov 2020

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
12 Oct 2026, 11:11 UTC
Study results updated
Version 1
9 Oct 2026, 03:04 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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