Weight Loss Lowers the risk of Heart Attack and Stroke
Today, November 11th 2023, represents a tipping point in the treatment of obesity.
For decades, doctors have viewed obesity as a cosmetic issue, and have resisted treating it with medications due to safety concerns prompted by drugs of old like “Fen-phen” which were released with inadequate safety studies and resulted in harm.
Today, for the first time, we have compelling evidence that not only is treating obesity with medications safe, but in fact treating obesity with medications lowers the risk of heart attack and stroke.
Novo Nordisk released the results of their SELECT trial today at the American Heart Association meeting. In this study, over 17,000 adults with obesity and heart disease were randomized to treatment with Wegovy (semaglutide 2.4 mg) for chronic weight management or placebo.
Those treated with Wegovy decreased their risk of a heart attack or stroke by 20%.
Not only is treatment with Wegovy for chronic weight management safe, but in fact, it lowers the risk of a major adverse cardiovascular event similarly to treating hypertension with medication or hyperlipidemia with medication. This is also similar to the risk reduction in cardiovascular events with the treatment of diabetes with Ozempic (semaglutide 1.0 mg).
People with obesity have a significantly elevated risk of developing heart disease. We can no longer afford NOT to treat! This is the first of many studies looking at the effects of chronic weight management with anti-obesity medication on heart risk. This study also demonstrates why it is critical to choose FDA-Approved treatments over those that have not been thoroughly studied in humans (such as “Compounded” peptides, available through the internet and med spas).
Of course, all treatments have potential benefits and risks. It is important to review all of the available options and choose the one that makes the most sense for your health.
And remember, while losing weight may help you feel better, look better, and be a smaller size, for people at elevated risk of heart disease, losing weight can also save your life.
Can losing weight on your own be as beneficial to the heart vs Wegovy giving people a 20% reduction in cardiac events.
What a great question! In Select, the separation between placebo and the treatment arm starts happening right at the beginning. This suggests that the cardiac protection of Wegovy is from the drug, and not necessarily from the weight loss. There is evidence that a 20% weight loss can significantly reduce heart attack risk, but this weight loss was achieved with surgery. There is not good evidence whether or not losing weight on your own provides the same cardiac benefits as losing weight with surgery or with Wegovy. I have long been taught that reducing your weight lowers your risk of heart disease; however, it is hard to compare diet/exercise driven weight loss to Wegovy-driven weight loss. Also, remember, this study was for RECURRENT events, not for a FIRST event. So, if you have had an event, Wegovy is probably the best choice at this time; however, if you have not had an event but are at risk, all options should be considered.