Weight-loss medications can improve heart health
At a glance
- Weight loss medications have benefits beyond weight loss and treating diabetes
- A recent study shows semaglutides cut the risk for major heart events by 20 percent
- It’s important to take weight-loss medications under the supervision of a provider for the best results
In recent years, medications called semaglutides — which mimic the hormones in your body that regulate appetite, food intake and blood sugars — have transformed the landscape of weight management.
These medications were originally developed for treating Type 2 diabetes, but have shown effectiveness in promoting weight loss. Additional health benefits continue to be discovered, including positive impacts on cardiovascular health.
“These medications are showing that they are effective at treating heart disease, not just weight,” says Valerie Sutherland, MD, MultiCare obesity medicine doctor.
A recent study called the SELECT trial investigated the cardiovascular effects of semaglutides. It showed a 20 percent reduced risk of major adverse cardiac events in people who are overweight or have obesity and have heart disease but not diabetes — since this medication effectively treats diabetes.
The medications also show improvement in heart failure, blood pressure and metabolic-associated liver disease.
The heart-weight connection
The relationship between excess weight and cardiovascular disease is well known. Extra weight increases the risk of high blood pressure, Type 2 diabetes, heart failure, atrial fibrillation, abnormal blood lipid levels and atherosclerosis (the buildup of fats in artery walls).
These conditions contribute to an elevated risk of heart attack, stroke and other cardiovascular events. Doctors have traditionally recommended weight loss as a way to improve these risk factors, but achieving and maintaining a healthy weight can be challenging.
Because semaglutides promote weight loss, they also benefit the heart by:
- Reducing cardiac workload: Every pound lost eases the burden on the heart, requiring less effort to pump blood throughout the body.
- Decreasing visceral fat: The medications appear to be particularly effective at reducing the abdominal fat that surrounds organs.
- Improving insulin sensitivity: By enhancing how the body responds to insulin, semaglutides help prevent or improve diabetes, a major risk factor for heart disease.
- Alleviating sleep apnea: Losing weight can improve or eliminate sleep apnea, which is associated with an increased risk of heart rhythm issues and heart failure.
“When people lose the amount they’re losing with these medications, we are de-prescribing other medications,” Dr. Sutherland says. “They may not need a CPAP or blood pressure medication. Their overall health is better, and the disease burden is lower.”
Get guidance from a trained provider
“These medications are powerful tools,” Dr. Sutherland adds. “Like all tools, if you use them wisely, you can reduce side effects.”
The risk of side effects can be minimized and managed, but it takes some knowledge from an experienced provider. For instance, starting at a lower dose allows the body time to adjust. After about four weeks, the digestive tract can acclimate.
The SELECT study followed people on semaglutide for about three-and-a-half years and showed that weight loss is sustainable, as long as the person stays on the medication.
Dr. Sutherland likens these medications to blood pressure or cholesterol medications: If you take it and your numbers go down, you keep taking the medication; you don’t stop.
“That’s why I like to think of these medications as weight-management medications, not just weight-loss medications,” she says. “It’s a long-term commitment.”
She also stresses the importance of support from a trained health care provider.
“People have varied results with using these medications,” Dr. Sutherland explains. “To get the best experience, you want expertise.”
At MultiCare, providers supervise medication usage to ensure safety and effectiveness.
“We do blood work and have check-ins every month for three months, then about every three months for a year, then every six months thereafter,” adds Dr. Sutherland.
The benefits of medical weight management
Obesity is a chronic medical condition that’s diagnosed and addressed like any other condition.
“It isn’t just calories in and calories out,” says Dr. Sutherland. “It’s not just a weight issue; it’s about metabolic dysfunction. We treat it in the context of one’s overall health care.”
The medical weight management program at MultiCare takes many aspects of a person’s health into consideration. The team looks at the health impacts and causes of weight and assesses medications, blood work and body composition.
“We look at what kind of extra weight a person has — is it visceral (wraps around internal organs) or subcutaneous (just under the skin)? How is their weight distribution? Is it in the trunk and upper body, or in the lower body?” Dr. Sutherland explains. “The impacts and risks depend on the type and distribution.”
‘The right tool for the right person at the right time’
While semaglutide and similar medications offer promising benefits for heart health, these drugs are most effective when used as part of a comprehensive approach to cardiac wellness, including lifestyle changes like regular physical activity and heart-healthy dietary choices.
“At MultiCare, our program includes surgeons, bariatricians and dietitians because we want to offer a comprehensive, patient-centered approach for long-term health,” Dr. Sutherland adds. “It’s not just diet or surgery or medication; it’s about finding the right tool for the right person at the right time.”
