The weight-loss drug semaglutide significantly cuts the risk of heart attacks and strokes, even when users lose little or no weight, according to the largest study of its kind published in The Lancet.
Researchers from University College London analysed data from 17,604 adults aged 45 and over across 41 countries who were overweight or obese. Participants were randomly given weekly semaglutide injections or a placebo. Results showed that semaglutide lowered the risk of major heart events — including heart attacks, strokes, or heart-related deaths — by 20%, regardless of weight loss.
However, the study also found that reductions in waist circumference, which reflect a decrease in abdominal fat, were linked to better heart outcomes. Researchers estimated that about one-third of the drug’s cardiovascular benefits were related to shrinking waistlines, while the rest came from other, as-yet-unidentified effects.
Lead author Prof John Deanfield said the findings suggest semaglutide directly improves heart health beyond its role in weight loss. “Abdominal fat is particularly harmful for cardiovascular health, but two-thirds of the benefits we observed can’t be explained by weight reduction alone,” he said.
The study indicates that even people who are only mildly overweight — with a BMI of around 27 — could experience significant cardiovascular protection. Deanfield said the findings challenge the idea that semaglutide should be reserved only for the most obese patients. “If the goal is to reduce heart disease, limiting use to those with high BMI doesn’t make sense,” he added.
Researchers stressed, however, that wider use of the drug must be balanced with careful monitoring of potential side effects, as semaglutide and similar treatments could soon be prescribed to much broader groups of patients.
