By Kevin Kolodziejski
And Two Health Studies That Suggest the Same
You’d think cause and effect is a simple concept. If you’re out on a ride and it begins to rain, for instance, the best bike handling skills in the world don’t mean squat. It doesn’t matter if you’re Wout van Aert, Mathieu van der Poel, or Peter Sagan or for that matter.
There’s no way in the world you’re dodging those water droplets. No how. No way. You get wet. There’s no doubt about it.
What is in doubt is what happens next.
What Happens After You Get Wet?
You might take off your sunglasses to see a bit better. You might put on your rain jacket to stay warm. You might lessen the air pressure in your tires for that extra bit of traction. You might forget there’s only one Peter Sagan and wind up opposite of upright in the next turn.
Then again, you could simply say, “Screw it,” and head home early.
What’s the purpose in chronicling these four scenarios? To explain why the phrase “You’d think” begins this article. To make the argument that while cause and effect is in essence a simple concept, it’s also a misnomer. That to be really accurate in virtually every situation, you should say, “Cause and effects.”
Because any effect almost always creates an effect or effects of its own. And for you to be really healthy and the best possible cyclist, you need to be aware of that.
Why You Should Always Add the S
Examples of why you should always add the s are found in two papers that were presented four weeks ago at ENDO 2026, the Endocrine’s Society’s annual gathering held this year in Chicago. The first paper contains a surprising after-the-effect effect resulting from a well-established one. That being if you’re obese and take a GLP-1 receptor antagonist medication like Ozempic, Trulicity, Rybelsus, Mounjaro, Zepbound, or Wegovy, you’ll lose weight.
But what study lead Sajana Maharjan, MD, and colleagues at HSHS St. John’s Hospital in Springfield, Illinois set out to determine is what effect taking what most people call the GLP-1 agonists has on exercise. So they further analyzed the health records and Fitbit data collected on 753 predominantly middle-aged and female obese people as part of the National Institutes of Health’s ongoing All of Us Research Program. They discovered a subsequent effect that’s opposite of the one you’d expect.
“The common assumption,” Maharjan explains to Erik Swain in an article for Healio about the study, “is that losing weight makes movement easier and naturally encourages more activity. Our data suggest that assumption doesn’t hold in the real world.”
A Loss of Weight and Exercise
While using a GLP-1 agonist, the participants averaged 560 fewer steps a day when compared to their average number of steps per day before starting medication, a reduction 11 percent. Equally confounding is that the average amount of daily exercise time done at a moderate-or-more intensity level fell by 21.4 percent. Moreover, and as the press release about the study notes, neither age nor prior health problems influenced these reductions. And no matter how the numbers were crunched did they ever produce any evidence that the weight loss from the GLP-1 agonists led to increased physical activity.
Which is problematic, for the best way to make any weight loss last, drug-aided or not, is to increase the sorts of physical activities that promote or maintain muscle mass. So taking a GLP-1 agonist creates a catch-22, as well as a fine example of why the phrase really should be cause and effects.
More Effects from Effects
The second paper from ENDO 2026 that also proves adding an s is best finds a new secondary effect of obesity. While this metabolic disease that rewires how the body handles sugar and fat and leads to inflammation and other metabolic diseases also increases the likelihood of heart disease, it used to be that when it did, it took a long time. That no longer seems to be the case.
By reviewing the Global Burden of Disease 2023, a study that incorporated mortality registries, hospital records, surveys and surveillance systems from 204 countries, researchers found that the incidence of heart disease now peaks in people aged 50-54 rather than the elderly. They also uncovered that the heart disease rate in South Asia has grown more than three times faster than the global average.
Which makes sense — and aids the argument to change the phrase to cause and effects — once you consider data collected between 2021 and 2023 as part of the Global Diet Quality Project. It found that consumption of unhealthy foods by adults, a relative rarity before the deluge of ultraprocessed foods so loved by Westerners rained down upon them, is now common in South Asia.
The second ENDO paper also projects that by 2050 more than 1.37 million premature cardiovascular deaths will result from obesity every year. In a press release about their study, one of its authors, Hardik Dineshbhai Desai, M.B.B.S, of the AB Plus Multispecialty Hospital in Ahmedabad, Gujarat, India, calls their projection “a wake-up call to the world.”
‘A Wake-Up Call to the World’
Which, albeit ambitious and maybe even delusional, is also the goal of this article.
But if you’re not feeling exactly bright-eyed and bushy-tailed at this moment, consider this projection from the presser by way of the World Obesity Federation. That obesity effects not only the world’s health but also its economy. That the global economic impact of obesity will reach $4.32 trillion per year by 2035 — roughly percent of global GDP, comparable to the hit the world economy took from the COVID-19 pandemic in 2020.
Kevin Kolodziejski began his writing career in earnest in 1989. Since then he’s written a weekly health and fitness column and his articles have appeared in magazines such as “MuscleMag,” “Ironman,” “Vegetarian Times,” and “Bicycle Guide.” He has Bachelor and Masters degrees in English from DeSales and Kutztown Universities.
A competitive cyclist for more than 30 years, Kevin won two Pennsylvania State Time Trial championships in his 30’s, the aptly named Pain Mountain Time Trial 4 out of 5 times in his 40s, two more state TT’s in his 50’s, and the season-long Pennsylvania 40+ BAR championship at 43.
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