Key Takeaways

There are no currently approved medications that can effectively help patients manage weight while reducing the risk of cardiovascular events, according to Martin Holst Lange, executive vice president for development at Novo Nordisk.

“SELECT is a landmark trial and has demonstrated that semaglutide 2.4 mg has the potential to change how obesity is regarded and treated,” Lange said in apress statement.

The trial enrolled 17,604 adults aged 45 or older who did not have diabetes. They did have a history of heart disease and abody mass index(BMI) of 27 or more.

BMI is a dated, flawed measure. It does not take into account factors such asbody composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.

Semaglutide, the active ingredient in Wegovy, has already been shown to reduce heart disease risks in people with type 2 diabetes.The SELECT trial was the first to show that semaglutide reduced the risk of cardiovascular events in people with obesity living without diabetes.

The full study results will be available later this year, and the drugmaker said it will ask the Food and Drug Administration (FDA) to expand the label indication for Wegovy.

“If the final trial results in publication also supports this result, then there is no doubt that this would be a class of drugs that cardiologists will need to embrace in helping our patients to reduce events,” saidBeth Abramson, MD, MSc, FRCP, a professor of cardiac prevention and women’s health at the University of Toronto and member of the prevention counsel at the American College of Cardiology.

What’s the Difference Between Ozempic, Wegovy, and Mounjaro?

What the Trial Results Mean for the Future of Weight Loss Drugs

It’s well-established that losing weight in a healthy way—with or without medications—can help to improve blood pressure, cholesterol levels, and diabetes control, Abramson said.

Semaglutide belongs to a class of medications called GLP-1 agonists, and decades of research indicate that GLP1 drugs have potential health benefits beyond helping patients lose weight.

It makes sense that a weight loss medication would also reduce the risk of so-called hard outcomes, like heart attack, stroke, and heart-related death, saidSteven Heymsfield, MD, a professor of metabolism and body composition at Louisiana State University.

It’s not entirely clear whether Wegovy and other GLP drugs like Ozempic and Mounjaro may cause changes in the body that bolster heart health beyond just promoting weight loss.

Previous studies on weight loss regimens had failed to show that weight loss could lead to reduced risk of cardiovascular outcomes, Heymsfield said. But the successes of GLP-1 drugs are reigniting conversations about whether weight loss can bring about significant health impacts beyond cosmetic changes.

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“People were asking, ‘Does weight loss improve their health in any way? And should insurance pay for it, if it doesn’t do anything beyond cosmetic?’” Heymsfield said. “This trial will definitely be the first benchmark and answering that question.”

Medicare and many private insurers don’t cover weight loss medications. At $1,400 per month, the cost of Wegovy without insurance coverage can be prohibitive for many patients. If data shows that weight loss drugs are effective for people at risk of heart disease, insurers will likely face increased pressure to cover them.

“The insurance companies always hid behind this idea that we don’t have hard endpoints on these things,” Heymsfield said. “That’s been their way of dodging paying for it.”

The SELECT trial results may not be applicable to people with obesity who don’t already have heart disease. Heymsfield said it’s possible that insurers will refuse to cover Wegovy for patients who have normal levels of triglycerides, HDL, and other markers of metabolic health.

An Oral Version of Wegovy Appears as Effective as the Injectable Version

What to Expect from the Full Trial Results

Heymsfield said he’s looking forward to learning more about the adverse events identified in this study. Rapid weight loss can commonly cause gallstones. And many patients who have taken Wegovy and other GLP1 drugs report experiencing nausea, diarrhea, and vomiting so bad they had to stop the medication.

“These are sick people to begin with. They’re obese and they’ve had a heart attack already. So, I think it’s a real acid test for the drug,” Heymsfield said.

Abramson, who’s a cardiologist, said that Wegovy will be added to the healthcare provider’s toolkits if they’re proven effective for heart health care. But it’s unlikely for Wegovy or Ozempic to become a foundational drug for treating heart disease. Drugs like statins, cholesterol-lowering drugs, and drugs that control blood pressure will continue to be the best ways to reduce heart disease risk, she said.

“I think we have to be cautious and say that this is not a magical wand to reduce all forms of heart disease,” Abramson said. “I don’t think this is a quick fix. And it’s not a one size fits all.”

Novo Nordisk said it’s considering testing semaglutide as a way to prevent heart disease in high-risk people. But there are no such trials planned.

For now, Abramson said the findings show the importance of maintaining a healthy weight to avoid heart health issues.

New Weight Loss Drugs Are on the Way That Could Upstage Wegovy and Ozempic

What This Means For YouIf you are a person with obesity or overweight status and concerned about your heart health, speak with your provider about the best ways to manage your lifestyle and medications.

What This Means For You

If you are a person with obesity or overweight status and concerned about your heart health, speak with your provider about the best ways to manage your lifestyle and medications.

1 SourceVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141

1 Source

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Marso SP, Bain SC, Consoli A, et al.Semaglutide and cardiovascular outcomes in patients with type 2 diabetes.N Engl J Med. 2016;375(19):1834-1844. doi:10.1056/NEJMoa1607141

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