The weight-loss drug semaglutide—best known as the active ingredient in Wegovy—reduces the risk of heart attacks and strokes regardless of how much weight people lose, according to a major global study published in The Lancet.
Researchers from University College London (UCL) examined data from 17,604 adults aged 45 and over, all of whom were overweight or obese. Participants were randomly assigned either weekly semaglutide injections or a placebo across 41 countries.
Results showed that semaglutide cut the risk of major cardiovascular events by 20%, and this benefit remained consistent whether participants lost a lot of weight or only a little. The findings suggest that the drug improves heart health through mechanisms beyond weight loss alone.
However, reductions in waist circumference—a marker of abdominal fat—were linked to better outcomes. Researchers estimated that around one-third of the heart benefits were related to shrinking waistlines.
Lead author Prof John Deanfield of UCL said: “Abdominal fat is more dangerous for cardiovascular health than overall weight, so it’s not surprising that a smaller waistline helps. But two-thirds of semaglutide’s heart benefits remain unexplained—it appears to directly impact heart disease and other age-related conditions.”
Deanfield added that these results challenge the view that semaglutide should be reserved only for those with severe obesity. “You don’t need a very high BMI or dramatic weight loss to gain cardiovascular benefit,” he said, though he cautioned that side-effects must be considered as use expands to broader patient groups.
