Can Losing Weight Using Semaglutide Prevent a Heart Attack, Ack, Ack, Ack, Ack?

Authors:
Gregory Castelli, PharmD, BCPS, BC-ADM, CDCES
Drake Meaney, PharmD, BCPS

Reviewers:
Jennifer Clements, PharmD, BCACP, BCPS, CDCES, BC-ADM
Jason Zupec, PharmD, BCACP

Citation:
Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232.

The Problem

Weight extremes, a body-mass index (BMI) either very underweight or obese, are associated with increased all-cause mortality.¹ While mortality from malnutrition inherently makes sense, mortality attributable to obesity is caused by many secondary conditions like metabolic disorders and cardiovascular (CV) disease. Enter the glucagon-like peptide-1 (GLP-1) receptor agonists—initially approved in the treatment of type 2 diabetes— which induce significant weight loss regardless of diabetes status.  Semaglutide, for example, given as a 2.5mg injection once weekly for two years, reduced body weight by a mean of 15.2% in patients with obesity but without diabetes.¹  But can this weight loss decrease CV mortality?