Summary: Researchers unmasked a critical behavioral paradox in modern weight management, proving that adults utilizing glucagon-like peptide-1 (GLP-1) receptor agonists experience a significant, measurable decline in daily physical activity.
Utilizing un-coerced wearable sensor tracking data from the National Institutes of Health (NIH) All of Us Research Program, the team analyzed Fitbit activity records alongside electronic health records of adults managing obesity.
The findings revealed that instead of naturally moving more as they shed weight, patients experienced a sharp drop in both daily step counts and moderate-to-vigorous physical activity (MVPA) minutes, creating a severe physiological risk given that exercise is mandatory to protect critical lean muscle tissue during rapid weight loss.
Key Facts
Dismantling the Activity Assumption: Clinical medicine has long assumed that significant weight loss naturally triggers an automatic, spontaneous increase in a patient’s physical activity. This large-scale tracking trial formally disproves that assumption, revealing that metabolic weight loss actually correlates with reduced daily movement.
The Threat to Lean Muscle Mass: GLP-1 receptor agonists like semaglutide, liraglutide, dulaglutide, and tirzepatide do not selectively target fat tissue alone; they also reduce vital lean muscle mass. This reality makes targeted, consistent resistance training and physical activity mandatory to preserve strength and protect long-term metabolic healthspan.
Leveraging Real-World Fitness Trackers: This project represents the first major medical study to analyze continuous, real-world data from wearable fitness trackers among a large cohort of adults taking GLP-1 receptor agonists, shifting away from notoriously unreliable patient-completed exercise journals.
Quantifying the Exercise Deficit: The data revealed a substantial drop in physical output across the board. On average, participants saw their daily step counts drop from 5,047 down to 4,487 steps per day, while their high-value moderate-to-vigorous physical activity (MVPA) fell from 28 down to just 22 minutes per day.
Identifying High-Risk Drop Off Zones: While variables like chronological age, chronic heart failure, or a history of stroke did not alter the downward exercise trend, the sharpest physical activity declines were isolated in male participants and in individuals battling pre-existing joint or muscle pain.
Robust Multi-Center Cohort Metrics: The retrospective pre-post study design filtered data from 1,950 adults within the NIH database who initiated GLP-1 therapy. The team isolated 753 individuals who possessed comprehensive, long-term wearable device data for high-fidelity analysis, yielding a cohort that was 78.6% female with a mean age of 52.7 years.
A Mandate for Targeted Clinical Interventions: Dr. Maharjan emphasizes that these findings demand a major evolution in how anti-obesity drugs are prescribed. Because exercise cannot be treated as an optional lifestyle recommendation, future weight loss protocols must pair the medication with structured behavioral interventions to enforce muscle-preserving movement.
Source: Endocrine Society
Adults with obesity losing weight with glucagon-like peptide-1 (GLP-1) receptor agonist medications significantly decreased their physical activity, which is essential to protect muscle, according to a study being presented Saturday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Ill.
GLP-1 receptor agonists like semaglutide, liraglutide, dulaglutide and tirzepatide reduce not only fat but also lean muscle mass. This makes physical activity essential for preserving strength and long-term health, according to study lead Sajana Maharjan, M.D., of HSHS St. John’s Hospital in Springfield, Ill.
The retrospective pre–post cohort study used data from the National Institutes of Health’s All of Us Research Program, which links participants’ electronic health records with their Fitbit activity data. Among the 1,950 adults with obesity who started a GLP-1 medication, researchers studied 753 people who had enough wearable-device data for analysis. The cohort was predominantly female (78.6%) with a mean age of 52.7 years.
Researchers compared each person’s physical activity before and after starting treatment, focusing on daily step counts and moderate-to-vigorous physical activity (MVPA) minutes.
On average, daily steps decreased from 5,047 to 4,487 steps per day, and MVPA minutes fell from 28 to 22 per day after beginning a GLP-1 receptor agonist medication. The largest declines were seen in men and in people with joint or muscle pain, while factors such as age, heart failure or prior stroke did not change the results. The study found no evidence that weight loss from these medications led to increased physical activity.
“While many assume that weight loss leads naturally to increased physical activity, our study suggests otherwise. The findings in our study reinforce that exercise cannot be optional for people taking these medications. People need targeted interventions that encourage physical activity alongside medication for obesity,” Maharjan said.
This is the first large study analyzing data from wearable fitness trackers among adults taking GLP-1 receptor agonists.
Key Questions Answered:
Editorial Notes:
This article was edited by a Neuroscience News editor.
Journal paper reviewed in full.
Additional context added by our staff.
About this exercise and GLP-1 research news
Author: Jenni Gingery
Source: Endocrine Society
Contact: Jenni Gingery – Endocrine Society
Image: The image is credited to Neuroscience News

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This article is part of “Unaffordable America,” a series examining rising economic inequality in the U.S. and the policies that drive it.
Soon after Aliea Brown rented Unit 62 at the Buck Island Manufactured Home Community in northern Mississippi in 2023, it became clear she couldn’t stay.
The front door was hung upside down, Brown said, black mold began growing throughout the unit and the windows weren’t sealed properly. Termites and ladybugs invaded. Then when it turned cold, a sewer pipe burst, increasing her water bill and causing putrid wastewater to collect under the unit for months.
“The rancid sewage smell came up through the cracks in the edge of the floor in the bathroom,” said Brown, 41, who pays $675 a month for the two-bedroom home she shares with her partner, Mason Obradovich, 39. “Unfortunately, the closest scent that it could be compared to would be a dead body.”
Lacking the funds to move out, Brown and Obradovich asked repeatedly for repairs while putting up with the harsh conditions as best they could. But this past February, Homes of America, the corporate owner of the park, sent Brown a letter saying the costs associated with repairing the mobile home “exceed the current value of the unit” and it was no longer available as a rental.
Buck Island offered to sell the dilapidated unit to Brown for $1,000, funded partially with her security deposit. The park is transitioning from a rental property, the manager said in an email, to a community in which residents must own their units.
After the couple declined to purchase the unit, they were told to leave by April 30. But they said they had nowhere to go.
“I’m disabled and the company is well aware of this,” said Brown, who has chronic obstructive pulmonary disorder, or COPD. “Our credit’s not great. We’re stuck here.”
About 22 million people live in mobile home communities across the U.S. They are among the only options for Americans unable to afford a house or higher-cost rentals. But in recent years, mobile home properties have become less affordable as an influx of large corporations and investment firms have bought up the parks and raised rents and fees, experts and residents say, further endangering some of the most economically vulnerable Americans at a time of rising income inequality.
NBC News interviewed 20 residents of manufactured home communities in Florida, Illinois, Mississippi and New Hampshire. They described significant changes and challenges in their communities after they were purchased by investment firms or large corporations. In addition to higher rents and fees, these people said, maintenance and services declined and relations between management and residents sometimes became toxic.
“Some of the new owners seem to deal with their residents in a fairer way and some are just ruthless,” said John Calabrese, president of the Florida Federation of Manufactured Home Owners and head of the Colony Cove Homeowners Association in Ellenton, Florida. “They have no concern whatsoever for the people that live there. The main focus is generating revenues.”
Buck Island, a 192-lot mobile home property, is located 35 miles southwest of Memphis. It’s one of 170 manufactured housing communities across 22 states owned by Homes of America, an affiliate of Alden Global Capital, an investment firm best known for buying newspaper properties, selling their assets and laying off workers.
Jessica Calvert, manager of the Buck Island community, declined to comment on questions about Brown’s experience there.
Homes of America’s main office did not respond to an email from NBC News containing detailed questions about its operations and parks. Alden Global Capital did not respond to phone messages seeking comment.
Jennifer Ludovice, a spokeswoman for Equity LifeStyle Properties — the owner of Colony Cove, where Calabrese lives — said the company works hard to “provide a community that residents are proud to call home.”
She added that rent increased an average of 4.2% annually between 2017 and 2026 and that its costs are “attractive compared to other housing options in the area.”
No bar on takeovers
There are 7.2 million occupied mobile homes across the U.S., accounting for 5.4% of the nation’s housing, according to census data. Many park residents are seniors on fixed incomes, people with disabilities and families with limited means. Most of the communities are in Southern states, such as Florida, Louisiana and Mississippi; in New Mexico, 15% of homes are manufactured housing, the highest percentage in the nation.
Although the costs of buying a manufactured home are rising, they remain well below what it costs to buy a new single-family home, data shows. The U.S. census says the cost of a new mobile home averaged $131,200 in 2025, compared with $530,000 on average for a new single-family home in 2025, according to the Federal Reserve Bank of St. Louis, which includes the cost of the land. Owners of mobile homes typically rent the land under their units and pay for utilities and homeowners association fees.
In January, President Donald Trump called for a moratorium on the purchase of single-family homes by institutional investors, contending that those purchases make it harder for people to achieve the American dream of homeownership. The 21st Century Road to Housing Act, which is moving through Congress, includes a ban on institutional investors purchasing single-family homes.
The bill contains no such prohibition on mobile home takeovers, and the president did not mention such purchases in his January order.
Some states are taking up the issue. Maine recently passed four laws protecting mobile home residents, including giving them the right of first refusal when their parks are for sale, allowing them to purchase the communities themselves. And the Michigan Senate recently passed a bill that would increase the regulation of mobile home parks, beefing up protections for residents. The bill is in the Michigan House.
‘Abandoned Trailer’ scheme
The black mold and eviction threats Brown says she experienced at Buck Island are not uncommon among residents at Homes of America communities in Mississippi, Louisiana and Texas, according to a lawsuit filed by a former employee in March.
Elvin Zapata, a regional manager overseeing Homes of America properties in those states from 2024 to 2025, filed suit against the company in 2025 alleging it fired him after he criticized its practices.
Zapata’s court filing said it was a company practice to conceal mold in units from residents, skipping professional remediation to save costs and prohibiting written documentation of mold in company records. He also said the company targeted renters with poor credit and low incomes to achieve occupancy quotas for its parks and that when the residents missed rent payments, it carried out immediate evictions.
Zapata also described what he called Homes of America’s “Abandoned Trailer” scheme in which the company sold ramshackle units to low-income buyers for $1,000 to offload the financial burden of rehabilitating them.
Homes of America has not responded to the complaint and has until mid-June to do so, according to a court filing.
Zapata did not return a voicemail seeking an interview.
For more than a decade, Jim Hodgkins has lived with his daughter at Greenmount Station, a mobile home community in Belleville, Illinois. The property’s owners kept it clean and neat and made repairs quickly, he said, but that changed in 2022, when Homes of America bought the park.
It went “completely downhill,” Hodgkins said, with huge potholes in the roads and repair requests ignored.
On Thanksgiving 2024, Hodgkins’ heat went out when it was 18 degrees, he recalled. “I couldn’t get ahold of anybody for nine days,” he said. “I went nine days with no heat.”
Late last year, Homes of America began informing residents they’d have to buy their units or move, Hodgkins said. He chose to buy his unit solely to avoid uprooting his daughter, who has mental health issues, he said. He secured a long-term loan from Homes of America to buy the unit.
“What will happen in the future is a bit worrisome, as I cannot afford to handle any big-ticket repairs,” he told NBC News. “They raised the lot rent $100 and still are not making any needed repairs. Lots of homes are vacant.”
Greenmount Station did not respond to a request for comment.
A year into their stay at Buck Island, Brown and Obradovich contacted a state nonprofit, Housing Education and Economic Development, or HEED.
After reviewing their case, a HEED official sent a letter to Buck Island management.
“The maintenance and repair of her home has been grossly neglected for over a year” and has “deteriorated to the point of uninhabitability,” it read, according to a copy reviewed by NBC News.
HEED asked that Buck Island move Brown and her partner to a renovated unit. But the alternative homes offered to the couple were equally problematic, Brown said.
“We went and looked at the places and they were no better,” she told NBC News. “One had a bigger black mold spot.”
Facing eviction, the couple is working with a local Legal Aid attorney. Buck Island, meanwhile, has refused to accept rent payments for amounts owed, Brown said.
Many residents faced with having to buy their units are leaving the community, Brown said.
“But we don’t have the credit or money to go anywhere else,” she added.

A new experimental drug may offer hope for pancreatic cancer patients. One of deadliest types of cancer in the United States, an estimated 52,740 Americanswill die from the disease this year, according to the American Cancer Society.
Patients who received the drug lived a median of 13.2 months, compared with 6.7 months for those who received chemotherapy, according to results of a phase 3 clinical trial published in the New England Journal of Medicine on May 31.
Here’s a look at how pancreatic cancer develops, how the new drug daraxonrasib prevents its spread, and what comes next for those interested in accessing the treatment:
What causes pancreatic cancer?
The exact cause of most pancreatic cancers is not completely known, according to the American Cancer Society. However, the majority of pancreatic cancers occur when genetic mutations trigger uncontrolled growth of cells in the pancreas, eventually forming tumors. Experts estimate that up to 90% of cases are associated with gene mutations, such as RAS mutations (more on those below), which are linked to lifestyle and environmental factors.
Unable to view our graphics? Click here to see them.
How pancreatic cancer spreads within the body
Typically, RAS proteins function as molecular switches that control a cell’s growth, division and survival. They transmit signals from outside the cell to the nucleus, helping ensure that tissues grow and develop properly, according to the National Institute of Health.
“I like to think of the RAS gene as a light switch that, when mutated, is stuck in the ‘on’ position. This tells the cells to divide without stopping. This is why RAS is so important in the development of cancer,” said Dr. Christopher Lieu, associate director of clinical research at the University of Colorado Anschutz Cancer Center.
If the RAS proteins mutate and become stuck “on”, this can lead to uncontrolled cancer growth, as shown below.
How daraxonrasib works against pancreatic cancer
Daraxonrasib is taken orally as a daily pill. Once ingested, the drug targets cancer-causing mutations in pancreatic cells, and those “on-off” switches that regulate cell growth.
“By physically sticking to the active RAS protein, this large complex acts like a piece of tape over an electrical outlet. It blocks other proteins from plugging in and receiving the ‘grow’ signal,” Dr. Lieu said.
RAS-mutant cancers have long been difficult to treat with drugs because the protein is small and lacks clear binding sites for therapeutics. However, recent advances have enabled scientists to successfully target RAS, marking a shift toward more precise, personalized cancer treatments. Overall, daraxonrasib decreased the risk of death by 60% in patients with metastatic pancreatic cancer, a study found.
“Seeing this magnitude of benefit in a randomized phase 3 study is very encouraging for all patients with advanced pancreatic cancer and is a paradigm shift in this deadly disease,” Dr. Zev Wainberg, professor of medicine and investigator at the University of California, Los Angeles Health Jonsson Comprehensive Cancer Center and co-first author of the study, said in a news release.
Can daraxonrasib be used to treat other cancers?
Yes, daraxonrasib is being studied by researchers as a potential treatment for additional malignancies caused by RAS mutations. Those include lung cancer, colorectal cancer, ovarian and endometrial cancers, and cholangiocarcinoma (a type of bile-duct cancer), according to Revolution Medicines.
What’s next for the drug?
Daraxonrasib was given the green light to begin an early access program for some patients on April 30 by the Food and Drug Administration. It’s unclear when formal approval will occur, but if nothing negative occurs in the meantime, it might happen later in 2026, according to UCHealth.
CONTRIBUTING: Mary Walrath-Holdridge, Sara Moniuszko, Sara Martin and Ramon Padilla/USA TODAY
SOURCE Revolution Medicines, UCHealth, Cedars-Sinai, The American Cancer Society and USA TODAY research

Marshall’s Major headphones are now in their fifth iteration, an unusually long lifespan for the often-overlooked on-ear category. The original model launched the same year as the first iPad, and sixteen years later they’re still going strong — with one notable omission: active noise cancellation (ANC). That’s where the new Milton comes in. If the design looks familiar, that’s because it started life as an ANC version of the Major. Over time, it evolved beyond a simple update, becoming a distinct third pillar in Marshall’s headphone lineup, sitting between the Major and Monitor ranges.
The Milton enters an interesting space: premium on-ear ANC headphones. It’s a category that rarely gets much attention, but Marshall has over a decade of experience refining on-ears, and the user data that comes with it, I presume. The $230 headset comes with all the expected elements Marshall is known for — solid battery life, iconic Marshall design and a feature-rich companion app. The result is something that’s definitely category defining, just maybe not in the way you’d expect.
The Milton looks like a pair of Monitors squashed into the shape and size of the Major. That’s to say, the gold logo motif, rounded edges and the metal headband details are all borrowed from the Monitor. The general size and the square shape of the ear cups, that’s an obvious influence from the Major. If there is a word that fuses “understated” and “familiar” then that’s what the Milton is. Undermiliar, perhaps? You’ll find other unmistakable Marshall DNA in the tolex-like textured finish that mimics its amps and the ever-present, brass accented multi-purpose button.
Like the Monitor and Major before it, the Milton captures the spirit of the brand it represents without drifting too far into gimmick territory. I do think Marshall’s design language is more on the lifestyle side that will appeal to a younger audience, or one that wants to wear its rock/alternative/indie spirit on its sleeve (or, in this case, ears). If you don’t care two hoots about the aesthetic and are just looking for a lightweight, comfortable and well-made on-ear headphone, then the Monitor is also exactly that.
James Trew for Engadget
Inside the ear cups, a 32mm driver is running the show. Physical controls are sparse, with just the aforementioned multi-directional brass button on the right hand ear cup and a customizable button on the left which can be assigned to toggle ANC, EQ, Soundstage (spatial audio) or summon your voice assistant.
Although the Milton is a wireless headphone, there’s a USB-C to 3.5mm cable in the box for analog/wired listening. But you’ll still need to turn the Milton on for that to work, so sadly this isn’t a plan B should you run out of battery. You can also use a USB-C cable to connect to a phone or PC and listen that way, too. The Milton has a user-replaceable battery too, which should extend the prospective life of the headphones significantly. The ear pads are also removable and thus should be replaceable.
I’m going to come out and say it, Marshall’s companion app is maybe the best I’ve ever used. Headphone apps often feel like afterthoughts with clunky user interfaces. What’s worse, the features they include are often easier to just activate on the device itself. Marshall’s app is a trove of discovery and genuinely helpful.
For example, on the main home page, you can toggle between ANC, transparency mode or disable both. You can also do this with the buttons, but the app has an ANC “Level” option for deeper configuration. Below that is the EQ, where you’ll also find the adaptive loudness toggle. The app has some decent presets here, but you can make your own and save that as a preset too.
The software features just seem to stack up from here. The Milton supports Auracast, and it’s here in the app you can find and join broadcasts. Marshall has its own implementation of “spatial” audio called Soundstage and the app is where you can configure and activate it. Soundstage changes the audio so it’s more like listening to a speaker in a room, rather than the music being directly in your head. I can’t say I care for it myself as it often pushes the drums and basslines (aka, the best bits) down, but it’s a thing you can do if the more direct input of headphones is a bit overstimulating.
The Milton supports Spotify Tap via a double click of the M button. Press twice and you’ll be served up some music based on your listening habits. Sorta like an on-demand playlist for when you don’t know what to listen to. Either way, it’s here and there’s a section in the app to remind you how it works.
Other goodies you’ll find here include battery preservation tools, similar to the options in iOS that prevent an iPhone battery fully charging or lower the charging speed. You can also configure the power-off timer if you don’t like the factory defaults and want the Milton’s to go to sleep almost immediately after you stop using them — or up to eight hours later. As is increasingly common, the Milton’s support Apple Find My and Google Find Hub, and there’s a section in the app to guide you to set that up.
Marshall headphones tend to veer more towards the “fun and lively” type of sound over a flatter, higher-fidelity profile. That’s certainly what you get with the Milton, a slightly bass-forward, mid-scoop sound that works well for most popular genres. The good news is that EQ lets you neutralize the tuning almost instantly if it’s not your thing. Plus, configuring a sound profile to your liking is pretty easy.
The 32mm drivers feel pretty balanced to me, even when pushing everything to maximum. Bass never feels overcooked, and female vocals, hi-hats and other higher frequency sounds never sound shrill, sharp or sibilant. The flip side to that is, for my tired ears at least, it’s hard to find a huge amount of dynamic range in the sound on a European iPhone. When I listen to electronic music, for example, everything feels balanced and in tune, but perhaps a bit closer together on the gainstage than on something like Sennheiser’s HDB 630.
For an on-ear headphone, one that you will likely use as a daily driver in a variety of situations, Marshall probably made the right call in terms of making something that’s fun to listen to but also won’t tire your ears. If you were hoping for higher-resolution options, LDAC is included here, but you’re out of luck if aptX is your preferred codec of choice.
As for the ANC, the Milton is impressive but with a caveat. My apartment looks onto a fairly busy road in the center of a city. This road generates a fairly constant hum of traffic and engines which is usually a pretty good test of ANC. The Miltons do a great job of eliminating noise from the street, but there’s a certain extra quality I look for in ANC that’s harder to quantify. A stillness? A sense of calm as you activate it? That’s not quite present here, even if the factual noise reduction is decent.
This is likely because these are smaller, on-ear headphones with much less of a physical seal, so some perceptible ambient “vibe” may be perceptible even if it’s not straight up noise. By that standard, the ANC is impressive and probably some of the best I’ve experienced on this style of headphone.
It’s a bit awkward, because as I write this, the Miltons are still running off of the first charge I gave them with 10 percent still available. That’s after more than a week of daily active use. What I can say is that this lines up with Marshall’s claims of 50-plus hours of battery life with ANC enabled, and upward of 80 hours without noise cancellation. I’ve worn these for multiple hours, every day, in the gym, street and right now as I’m typing these words, and I haven’t had to charge them yet. I’ve had ANC active almost the entire time, too. That’s to say that the battery life on the Milton is good, even if you leave noise cancellation on.
There are no surprises that the Marshall Miltons are fun, comfortable and feature-rich. The heritage of the popular Major line clearly has been put to good use here to make an on-ear headphone for the more discerning listener. The ANC capabilities are strong for the form-factor, even if they might be considered more mid-pack if they were over ears. The sound experience is classic Marshall: A little heavier on the low and and higher mid frequencies, but the full EQ allows you to steer it more to your taste.
Ultimately, $230 might be a little on the pricey side for on-ears, but Beats has been charging that for its Solo 4 without ANC for long enough that a little bit of competition from the Milton is probably a good thing.