GLP-1s Move to Front of Line in Obesity Care, According to Cardiologists
Krissy Vann | Host, All Things Fitness and Wellness
A new consensus statement from the American College of Cardiology is updating the clinical approach to obesity management and outlines implications for adjacent sectors, including the fitness industry. The 2025 Concise Clinical Guidance on Medical Weight Management highlights an expanded role for obesity medications such as semaglutide and tirzepatide, which are part of a newer class of GLP-1 and dual GLP-1/GIP therapies. These drugs are now recommended earlier in treatment, not only for individuals with type 2 diabetes but also for those with obesity and cardiovascular risk factors, regardless of previous attempts at lifestyle modification.
Obesity continues to affect more than 40 percent of adults in the United States and is associated with increased risk of heart failure, coronary artery disease, and stroke. While traditional interventions such as exercise and dietary changes remain important, they have not shown significant impact in reducing cardiovascular events. In contrast, clinical trials of medications like semaglutide and tirzepatide have demonstrated 15 to 21 percent weight loss on average and reductions in cardiovascular outcomes such as heart attack and stroke. This has led to updated guidance that no longer requires patients to fail lifestyle interventions before beginning pharmacologic treatment.
For fitness operators, this shift may influence how they structure services for members managing obesity. Facilities are likely to encounter clients who are prescribed these medications as part of their initial treatment plan. The use of GLP-1 therapies is associated with rapid weight loss, which may result in decreased muscle mass if not addressed through strength training. Fitness programming that includes progressive resistance training may help mitigate this concern and is consistent with broader goals of maintaining functional capacity during weight reduction.
Some companies in the fitness space are already adjusting their models to reflect this clinical direction. Life Time has introduced a program that combines medical oversight with training and nutrition services. WeightWatchers and F45 have also partnered with healthcare providers to offer hybrid models that incorporate both clinical and lifestyle components. These developments align with the recommendation for multidisciplinary care teams, where fitness professionals play a supportive role alongside medical providers.
There may also be operational considerations. Staff education is one area where fitness businesses can respond, particularly by ensuring that trainers and coaches understand the basic mechanisms of GLP-1 medications, common side effects, and when to refer clients to a physician. Additionally, since long-term use of these medications is often required to maintain weight loss, clubs that provide sustained engagement and structured support could help clients maintain progress over time.
Access to these medications remains a challenge. High costs and variable insurance coverage may limit use for some individuals. This may prompt members to seek added value from the services they do access, including tailored fitness plans and education that supports their broader health goals. Fitness operators could also explore collaboration with healthcare providers or digital health platforms to meet evolving member needs.
The updated guidance reflects the growing clinical consensus that effective obesity treatment requires more than one intervention. For the fitness industry, this represents an opportunity to align with current standards of care and offer services that complement medical treatment. As the role of pharmacotherapy expands, facilities that adapt their offerings to support members using these medications may be better positioned to provide relevant, evidence-informed care.
