The use of GLP-1 drugs continues to expand rapidly, reshaping obesity treatment in the United States and around the world. For millions of patients, these drugs represent a major breakthrough in weight-loss care. For policymakers, payers, employers, and healthcare systems, they also represent one of the largest and most consequential healthcare investment decisions now unfolding.

Recognizing the importance of this emerging area, the Health & Fitness Association has commissioned new research that asks a question that has so far received little attention in the national conversation around GLP-1s: What helps ensure these treatments deliver lasting health and economic value?

From Weight Loss to Lasting Value: Structured Exercise and the Economics of GLP-1 Therapy was was produced by a team of PhD economists with specialized health economics expertise from FTI Consulting’s Center for Healthcare Economics and Policy.

The research models the added health and economic value created when structured exercise, especially strength training, is integrated into GLP-1 treatment pathways. It was developed to help the fitness industry present a compelling, credible case in healthcare and policy conversations. Policymakers and payers already understand that exercise is beneficial. The harder question is whether structured exercise can be measured as an intervention that improves outcomes, lowers downstream costs, and justifies coverage, reimbursement, tax-preferred treatment, or other forms of support.

Why This Research Matters

The public conversation around GLP-1 medications has largely focused on weight loss, prescription costs, access, side effects, adherence, and employer or insurer coverage. While these are important questions, they do not fully capture what happens after weight loss begins or how patients, payers, and health systems can get the most sustainable value from GLP-1 therapy.

Weight loss alone is not the full measure of success. Patients also need to preserve strength, mobility, metabolic health, and long-term function. Health systems need to know whether today’s spending translates into fewer costly health events tomorrow. Payers need to understand what complementary supports can make GLP-1 treatment more effective and economically sustainable. That is where structured exercise comes in.

GLP-1 medications can produce substantial weight loss, but that weight loss often includes loss of lean muscle mass. That matters because muscle loss can affect strength, mobility, independence, and long-term health. Structured exercise, particularly strength training, directly helps address that risk. Exercise may also help patients sustain healthier weight and physical function over time, including after medication use changes or ends.

The new research does not simply restate the well-established health benefits of exercise in the context of weight-loss drugs. It goes further by estimating the economic value of adding structured exercise to GLP-1 treatment. In other words, it translates the clinical and practical role of exercise into the kind of health economic evidence policymakers, payers, and healthcare leaders want.

The Numbers Tell the Story

In the United States alone, adding structured exercise to GLP-1 therapy is projected to prevent major costly health events. Over 10 years, compared with GLP-1 therapy alone, the combined approach is projected to avoid nearly 110,000 knee replacements, 50,000 hip replacements, 17,000 heart failure events, 15,000 heart attacks, and 15,000 strokes. Those improved outcomes translate into approximately $27 billion in avoided medical costs and $1 billion in avoided societal costs over 10 years.

Because the model assumes public or private support for structured exercise through coverage, reimbursement, subsidies, or similar access models, it also calculates the return on that investment. Factoring in all health and societal benefits, the combined approach is projected to generate an additional $120 billion in additional health and economic value over 10 years, with a 496% return on investment. Over 30 years, the projected return rises to 1,572%, with nearly $393 billion in net monetary benefit.

For payers and policymakers, the findings point to a clear conclusion: the value of GLP-1 therapy depends not only on access to medication, but also on the supports that help patients sustain improved health. Structured exercise is one of the most effective and economically compelling of those supports.

A Global Coalition, With a Clear Message

This initiative is part of a broader five-country research collaboration involving the Health & Fitness Association, the HFA Foundation, AUSactive, Exercise New Zealand, the Fitness Industry Council of Canada, and ukactive. The findings are consistent across the five markets analyzed. While the scale of the impact varies by country because of differences in healthcare systems, costs, and populations, the direction is uniform: integrating structured exercise into GLP-1 care produces positive long-term returns.

The multinational scope of the project reflects HFA’s broader commitment to building research partnerships across markets when doing so strengthens the industry’s evidence base and creates a more credible case for policy change. In this case, the five-country model shows that the opportunity is not isolated to one healthcare system. It is a broader challenge and opportunity for countries now wrestling with how to integrate GLP-1 medications into obesity care..