Could GLP-1 weight loss drugs also treat or prevent chronic diseases?

GLP-1 for heart disease

In March 2024, the U.S. Food and Drug Administration (FDA) approved the GLP-1 drug Wegovy (semaglutide) to treat heart disease in people who are overweight or obese – the first approval of a GLP-1 drug outside of diabetes or weight loss.

The approval came after participants in several GLP-1 trials saw a significant reduction in major heart attacks such as heart attacks and strokes, as well as a decrease in cardiovascular deaths, Isaacs says.

This was expected, given that obesity and being overweight are risk factors for heart attacks and strokes. But other medications and lifestyle interventions that have positive effects on blood sugar and weight haven’t shown such impressive results, Isaacs points out. “This indicates that there are mechanisms that go well beyond just losing weight or lowering blood sugar,” she says.

Weight loss in the SELECT trial was not particularly significant: on average, each participant lost about 8 to 9 percent of their body weight. “This leaves open the question of whether there might be another primary effect that has yet to be determined,” says Ard.

The SELECT trial was the first large randomized study to show that a drug used for obesity could reduce cardiovascular disease, Isaacs says. “This could change the paradigm of how we view overweight and obesity” — as cardiovascular risk factors and not just cosmetic problems — “and we hope to expand insurance coverage and access to these weight loss medications,” she says.