I started working out in 1970, after my older brother brought home a set of plastic-coated weights from Sears.

We had no idea what to do with those weights, but we knew exactly why we lifted them:

• To get bigger and stronger
• Which would make us better at sports
• Which would elevate our status among teenage boys and draw the attention of teenage girls

It didn’t matter that none of those things happened for me, at least not in the ways I thought they would. The biggest change happened north of my slightly wider but by no means impressive shoulders. Lifting progressively heavier things taught me the value of process and incremental gains.

I continued exercising for the next 56 years because I couldn’t imagine a version of myself that didn’t go to the gym at least three times a week.

At first I wondered why more people didn’t exercise. But then, I started to consider the perspective of someone who’s never experienced the value of working out — especially today, in the era of GLP-1s.

Losing weight is the classic carrot, but we now have medications that work much faster and more reliably. Same with a long list of physical and mental health concerns. Exercise may work as well as pharmacologic treatments (as research suggests it does) — but if it isn ’t inherently appealing, why do the hard thing when the easy one is covered by insurance?

Better question for doctors: How do you talk to patients about exercise when weight loss is no longer the default reason?

There are two equally strong answers. We’ll start with the most urgent.

Part One: the Physiology

From a biological perspective, the point of exercise is simple.

“So you can engage in things you like to do,” said Martin Gibala, PhD, a professor of kinesiology at McMaster University in Hamilton, Ontario, Canada, and author of The One-Minute Workout. “That requires a functional capacity that meets the nature of the things you want to do.” 

Functional capacity is a proxy for cardiorespiratory fitness (CRF). CRF describes oxygen uptake, or the ability of your lungs to pull oxygen from the air and deliver it to your heart and working muscles, where it’s used to generate energy. 

Higher CRF = more functional capacity. Just how much functional capacity you need depends on what you want to do. 

“Ultimately, it comes back to the oxygen uptake,” Gibala said. “What is the oxygen uptake that’s required to walk around? To climb a flight of stairs? To do household chores?” 

An easy way to frame this for patients is in terms of their MET value. MET stands for metabolic equivalent of task. One MET is the energy it takes to sit still and do nothing, which is 1 calorie/kg of body weight per hour. 

Four METs, or four times your resting energy expenditure, is considered the minimal capacity required for activities of daily living. 

For someone on that borderline, simple things like getting dressed (2.8 METs), walking the dog (3.0 METs), or cooking and washing dishes (3.3 METs) would require a significant percentage of their capacity. 

Loading and unloading groceries (3.8 METs) would be metabolically similar to a fitness enthusiast doing high-intensity intervals. Playing pickleball (5.3 METs) or ballroom dancing (6.0 METs) would be unthinkable. 

“If you’re very deconditioned, you’re asking your body to work at max all the time,” Gibala said. “It just can’t.” 

Functional capacity is highly modifiable for most people, and the rewards are huge. Increasing your CRF by 1 MET is associated with a 20% reduction in the risk of dying prematurely from any cause. That’s roughly the same survival boost you’d get from burning an extra 1000 calories/wk. 

What does it take to improve functional capacity? Less than you might think. Individuals can raise their capacity above 5 METs by regularly exercising at or above 3 METs. That’s a casual walk on a flat surface. 

In general, Gibala said, “the more vigorous, the better. But it doesn’t have to be all-out. It can be submaximal work but still improve functional capacity.” 

That submaximal work doesn’t have to be traditional cardio. In a 2021 study, Gibala and his team showed that a circuit of body-weight exercises improved peak CRF in a group of young but untrained participants. 

Older research has shown that resistance training can improve CRF, although the magnitude of the increase depends on the participants’ initial fitness level. Those with relatively low functional capacity saw the biggest increases. 

That’s in addition to the primary benefit of stronger muscles, which also make everyday activities easier — a difference patients will notice even before CRF improves. 

Whatever exercise you choose, the more you enjoy it, the more likely you are to stick with it long enough to raise your functional capacity and increase the menu of activities you can do without discomfort or fatigue. 

But how do you motivate yourself — or your patients or clients — to make that leap?

Part Two: the Psychology

“The point of exercise is to make the exerciser’s life better than it was without exercise,” said Natalia Mehlman Petrzela, PhD, a professor of history at The New School, in New York City, and author of Fit Nation: The Gains and Pains of America’s Fitness Obsession. 

“That can be about physical transformation. It can be about social transformation. It can be about psychological transformation.” 

Petrzela, who wasn’t conventionally athletic in her youth, has experienced all three.

She went from someone who got out of PE by taking aerobics classes at a local community center to a lifelong fitness enthusiast who still teaches exercise classes part-time.

“I was actually sort of dragged into exercise as a teenager,” she recalled. But then she discovered that “the practice of self-fashioning and changing my own body through my work was incredibly empowering in a way that certainly had knock-on effects in other aspects of my life.” 

Petrzela’s story illustrates perhaps the biggest challenge of explaining the point of exercise to a fitness skeptic. If you lead with, “You won’t know how it changes your life until you do it consistently for years,” you sound like you’re recruiting for the world’s least interesting cult. 

The short-term reality of exercise isn’t particularly enticing. “Exercise, if it’s going to be worth it, is hard,” Petrzela said. “It’s an interruption of your daily routine.”

That’s in addition to the barriers experienced by people who don’t live in safe, walkable neighborhoods, or lack social support, or don’t have access to facilities or childcare.

Again, from the perspective of a busy, exhausted patient, why bother?

Part Three: the Leap of Faith 

When I picked up a barbell for the first time, my 13-year-old self saw unlimited upside in the pursuit of strength, muscle mass, and athletic prowess. 

The reality of my limited potential eventually cauterized my fantasies in all three domains. Even then, for most of my adult life I’ve kept the desire to find something, anything, I could do better than before. 

But for many, the motivation to exercise comes not from what they want, but from what they no longer have. “It gets reverse-engineered in a negative way,” Gibala said. The focus is on what they can no longer do for themselves, like move a piece of furniture, or climb a ladder to clear out the gutters. “That’s just saying what you’ve lost: the capacity to do those activities you enjoy or need to do to be independent,” he said.

Research, however, shows “gain-framed” messages tend to be more persuasive, especially for increasing physical activity. Historically, as noted earlier, weight loss was the number-one reason for initiating an exercise routine. But that may no longer be the case. 

“What I hope happens with GLP-1s, and I think it kind of is, is that the fitness industry can stop selling weight loss” as the primary benefit of exercise, Petrzela said. “Instead, they can focus on longevity, strength, community, mental health, all of those things, which are much more realistic, positive outcomes.” 

Anecdotally, many patients who’ve lost weight with GLP-1s find it’s easier to exercise when they aren’t going back and forth between intense hunger and postmeal bloat. They also have another motivation: the much-publicized reduction in lean body mass with medication-induced weight loss. 

For them, Petrzela said, “it’s never been more important to do strength training.” 

And which is more appealing: pursuing exercise to shape and strengthen a leaner body, or enduring it as punishment for not being lean to begin with? 

That proactive logic can apply to anyone who’s on the fence about starting or resuming a fitness routine, regardless of their weight. 

With exercise, Gibala said, “you don’t feel as tired when you do a given thing.” The alternative is getting progressively more fatigued from mundane tasks like raking leaves or taking out the garbage. 

The rewards of exercise don’t stop there. 

“I think quite a few people undertake it for one reason and discover it has different sorts of benefits,” Petrzela said. “A very conventional narrative is, ‘I went to the gym to lose weight, and I ended up meeting amazing friends,’ or ‘I ended up getting so strong in a way I didn’t think I was capable of.’” 

When you experience those changes, you won’t need to ask what’s the point of exercise. But you may help someone else find the answer.

The experts cited in this article reported having no relevant disclosures.