Weight loss jabs like Wegovy and Ozempic have been shown to cut people’s risk of heart attack or stroke regardless of how much weight they lose – and belly fat is crucial
Weight loss jabs could cut people’s risk of heart attack or stroke regardless of how much weight they lose, research suggests.
New analysis shows losing belly fat is key to improving overall heart health, rather than overall weight loss – which can include loss of muscle mass. Scientists working on the new Lancet study say it “doesn’t make sense” to restrict the appetite suppressing to only the most severely obese, which the NHS is currently doing.
Lead author Professor John Deanfield, from University College London, said: “Abdominal fat is more dangerous for our cardiovascular health than overall weight and therefore it is not surprising to see a link between reduction in waist size and cardiovascular benefit.
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“However, this still leaves two thirds of the heart benefits of semaglutide unexplained. These findings reframe what we think this medication is doing. It is labelled as a weight loss jab but its benefits for the heart are not directly related to the amount of weight lost – in fact, it is a drug that directly affects heart disease and other diseases of ageing.”
The new study examined whether 17,604 users of the drug semaglutide – known by its brand names Wegovy for obesity and Ozempic for diabetes – went on to suffer a “major adverse cardiac event” such as heart disease death, heart attack or stroke. They were at least 45 years old who were either overweight or obese.
Half of the people taking part in the study – which was spread over 41 countries – were given weekly injections of semaglutide with the other half given a dummy drug, known as a placebo. Previous analysis of the data found that semaglutide reduced the risk of major adverse cardiac events by 20%. Now researchers have confirmed that the benefit was apparent regardless of how much weight people lost while taking the drug.
People with a body mass index (BMI) score of 27 – the average BMI score for UK adults – saw similar benefits as those who had the highest BMI scores. And the benefits were also largely independent of how much weight people lost in the first four months of treatment. It is thought heart benefits could be due to other effects of the drug such as reducing harmful inflammation in the body.
Researchers did notice a difference between shrinking waistlines, measured by waist circumference, and heart benefits. Their report said that an “estimated 33% of the observed benefit on major adverse cardiovascular events was mediated through waist circumference reduction”.
Prof Deanfield added: “This work has implications for how semaglutide is used in clinical practice. You don’t have to lose a lot of weight and you don’t need a high BMI to gain cardiovascular benefit. If your aim is to reduce cardiovascular disease, restricting its use to a limited time only and for those with the highest BMIs doesn’t make sense.
“At the same time, the benefits need to be weighed against potential side effects. Investigations of side effects become especially important given the broad range of people this medicine and others like it could help.”
The NHS in England is rolling out weight loss jabs to 240,000 people starting with those with the highest need over the next three years.
Prof Tim Chico, honorary consultant cardiologist at Sheffield University, said: “The implications of this and other similar studies are profound. The average man or woman in the UK has a BMI over 27, so most people with heart disease are likely to benefit from adding semaglutide to their existing drugs, which already usually include aspirin, statins, blood pressure lowering drugs, and other blood thinners.
“Evidence from this and other studies suggests we should consider giving these drugs to the very large number of people likely to get a meaningful benefit.”
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Dr Sonya Babu-Narayan, director at the British Heart Foundation, said: “These intriguing results demonstrate that the benefits of medications like semaglutide on heart health go beyond weight loss alone. But this leaves much unexplained. More research will be needed to unravel the other mechanisms of action behind the cardiovascular benefits beyond weight and fat loss, such as improvements in blood vessel health, control of blood pressure and blood sugar, or inflammation.
“We can’t yet know the potential impact of sustained use of medications like these, especially in cardiovascular patients who are not living with overweight and obesity.
“If you have been prescribed these drugs as part of your heart care, it’s important to remember that they are not a substitute for other things that keep our hearts and minds healthier for longer. This includes getting regular physical activity and trying to eat as healthy and nutritious a diet as possible, which will help to maximise your long-term heart health.”