Heart Benefits of Semaglutide Are More Than Weight Loss
A new study in Lancet tells us that we need a fundamental reframing of the medical benefits semaglutide can bring to a growing number of people around the world. In the simplest terms, researchers have found that the heart benefits of semaglutide actually have relatively little to do with weight loss. Professor John Deanfield was the lead author. He explains:
“Abdominal fat is more dangerous for our cardiovascular health than overall weight and therefore it is not surprising to see a link between reduction in waist size and cardiovascular benefit.
“However, this still leaves two-thirds of the heart benefits of semaglutide unexplained. These findings reframe what we think this medication is doing.
“It is labeled as a weight-loss jab but its benefits for the heart are not directly related to the amount of weight lost – in fact, it is a drug that directly affects heart disease and other diseases of ageing.”
New Findings from SELECT
These findings come from the treasure trove of data that is the SELECT study. The objective was to figure out how much of the reduction in heart attacks, strokes, and deaths that semaglutide provides is from weight loss and changes in adiposity. These were more than 17,000 patients with a history of cardiovascular disease. Half of them received a random assignment to receive semaglutide and the other half received a placebo. All of them had a BMI of 27 or more.
What this particular study of these data tells us is that it really didn’t matter how much a patient weighed at the start of the study. Nor did it matter how much weight they lost. Regardless of those two factors, the benefit of semaglutide for preventing heart attacks, strokes, and cardiovascular deaths was the same.
A change in waist circumference was better predictor of the benefit. But still, it only predicted a third of the benefit. The cardiovascular benefit of this drug for people with excess weight and a history of heart disease comes from something more than just a reduction in adiposity. The benefit appears to be a more fundamental change in cardiometabolic health.
Can We Please Stop Calling This a Weight Loss Drug?
Now more than ever, this brings us to a plea for respecting one of the fundamental truths of obesity treatment. The benefits are more much more than weight or fat loss. The real benefit is a whole range of health benefits that come from treating this complex, chronic disease.
Semaglutide is an exceedingly valuable obesity medicine. Calling it simply a weight loss drug is misleading. It helps in many other ways that we don’t yet fully understand. And that is exciting for people who devote their careers to understanding this disease for the benefit of people who live with it.
Click here for the study in Lancet, here and here for further perspective.
Heart of the Forest, painting by Emily Carr / WikiArt
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October 24, 2025
