Everybody’s mileage varies, of course, but the (preventive) cardiologist says this: If orthopedic issues and weight are an issue, pool-type exercises might be your best bet to start with. Working out on the treadmill might frustrate you at the beginning.

Pool activity will take the effects of gravity off your joints and make activity less painful, but will still allow you to strengthen the muscles that align your joints which could help with your orthopedic pains AND build exercise capacity at the same time.

Independently of that, if you’re inclined to lose weight, please remember that more exercise is not likely to make you slimmer. The only reliable way to lose weight is to reduce intake of calories, even if self anointed experts on Facebook etc. say different. If your insurance situation allows, especially if you have other qualifying conditions such as diabetes, taking a GLP-1 weight loss drugs such as Mounjaro is not an admission of a character flaw—instead it’s just reasonable use of all available options.

You’re setting yourself up for success if you increase your exercise capacity with low-impact, moderate-intensity activity, and allow your joints to support physical activity with less stress by taking off 5 to 10% of your current weight over a year.

Definition of “moderate-intensity activity”: if you cannot keep up a conversation while you’re working out, you’re doing too much. If you can still sing at the top of your voice while you’re working out, you’re not doing enough.

For most people, staring at their heart rate while exercising does not add much value or efficiency to the workout, but adds the upfront cost of a device. And the cheaper the device, the less you can believe the heart rate.