The weight-loss drug semaglutide – the active ingredient in Wegovy – reduces the risk of heart attack and stroke regardless of how much weight people lose, according to a major global study published in The Lancet.
The trial, led by researchers at University College London (UCL), analysed data from 17,604 adults aged 45 and over who were overweight or obese. Participants were given either weekly semaglutide injections or a placebo across 41 countries.
The study confirmed that semaglutide lowers the risk of major cardiac events by 20%, even in patients who lost little or no weight. This suggests the drug may protect the heart through mechanisms beyond fat reduction, such as improving blood sugar control or reducing inflammation.
However, researchers found that waist size – a marker of abdominal fat – did play a partial role. About one-third of the heart benefits were linked to reduced waist circumference, with shrinking belly fat offering measurable cardiovascular improvements.
Lead author Prof John Deanfield of UCL said:
“Abdominal fat is more dangerous for our cardiovascular health than overall weight, but two-thirds of the benefits of semaglutide can’t be explained by weight loss alone. It’s a drug that appears to act directly on heart disease and ageing.”
He added that the findings challenge current prescribing practices:
“You don’t need to lose a lot of weight or have a high BMI to gain cardiovascular benefit. Restricting semaglutide only to severely obese patients doesn’t make sense.”
The study strengthens the case for using semaglutide not just as a weight-loss treatment, but as a heart-protective therapy, though experts caution that potential side effects must be carefully monitored as its use expands.
