GLP-1 Receptor Agonists and Physical Activity: A Narrative Review of Their Effects on Body Weight, Body Composition, and Metabolic Health

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are highly effective in obesity treatment; however, the accompanying loss of lean body mass raises concerns regarding skeletal muscle preservation and long-term metabolic health. Combining pharmacological treatment with physical activity may help address these concerns. The aim of this narrative review was to summarize current evidence regarding the individual and combined effects of GLP-1 receptor agonists and structured physical activity on body weight, body composition, and metabolic health in individuals with overweight and obesity. A literature search was conducted in PubMed for publications available up to 13 June, 2026, supplemented by searches in Google Scholar and PubMed Central (PMC) and screening of relevant reference lists. Current evidence suggests that while GLP-1 receptor agonists effectively reduce body weight and fat mass, structured physical activity, particularly resistance exercise, plays a critical role in preserving lean body mass, improving insulin sensitivity, enhancing lipid metabolism, and promoting mitochondrial adaptations. The available literature indicates that combining pharmacological therapy with regular physical activity may optimize body composition and improve long-term metabolic health beyond the benefits achieved with either intervention alone. This narrative review highlights the complementary roles of GLP-1 receptor agonists and physical activity and supports the integration of pharmacological and lifestyle-based strategies as a comprehensive approach to obesity management.