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What This Means for Your Health
On March 8, 2024, the U.S. Food and Drug Administration (FDA) approved Wegovy for use in patients with cardiovascular disease.1 Wegovy is an injectable medication that has recently gained attention for aiding weight loss and has also been proven to help with obesity. The FDA’s approval of Wegovy for use by patients with heart disease was confirmation that data shows a significant reduction in the risk for cardiovascular events such as heart attack and stroke.
What is Wegovy
The FDA originally approved Wegovy in 2021 as a treatment for obesity in adults. Its approval was based on Ozempic, a drug with the same formulation but a lower dose for diabetes management that showed exceptional weight loss results. This injectable medication developed by Novo Nordisk contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Semaglutide works by activating GLP-1, a 30-amino acid peptide hormone produced in the intestine. When you eat, GLP-1 is released to help regulate blood sugar levels by stimulating insulin secretion and reducing glucagon release from the pancreas. By activating GLP-1 receptors, semaglutide helps improve insulin sensitivity, reduce post-meal glucose levels, delay stomach emptying, and decrease appetite. This leads to a calorie deficit, which results in significant and sustained weight loss when combined with diet and exercise.
The Link Between Obesity and Heart Disease
Obesity contributes to the development of various cardiovascular conditions, including coronary artery disease (CAD), congestive heart failure (CHF), atrial fibrillation (Afib), and stroke. Excess weight increases heart and blood vessel stress, leading to elevated blood pressure, dyslipidemia (a metabolic disorder), insulin resistance, and systemic inflammation. These changes increase the risk of developing atherosclerosis (the buildup of plaque within the arteries), which can lead to heart attack or stroke. Obesity can also lead to heart failure because of changes in the structure and function of the heart.
Effectiveness in Reducing Cardiovascular Risk Factors
Recent studies have shown that Wegovy not only aids in weight loss but also addresses several cardiovascular risk factors associated with obesity. Clinical trials have shown that treatment with Wegovy reduces high blood pressure, LDL cholesterol, triglycerides, and inflammation, lowering the risk of major cardiovascular events.
Clinical Trials and Findings
Approval of a drug by the FDA is vital to ensure its effectiveness. This is often a key element in insurance coverage for many new medications. One study showed significant cardiovascular benefits among participants with obesity or who were overweight. The study included a diverse population of individuals with high cardiovascular risk. It assessed the impact of Wegovy on major cardiovascular events such as heart attack, stroke, and cardiovascular death. The trial’s findings provided the evidence needed for the FDA’s approval.
Considerations of Its Use
We must establish that Wegovy is not a miracle drug. It has exceptional benefits, which we have not seen in other non-surgical weight loss options. However, it comes with considerations and risks. For one, patients may lose less weight than they expect. In clinical trials, only a fraction of the patient population lost more than 15% of their body weight. This means that for very obese patients, these injections may not be enough to eliminate their obesity-related diseases.
These drugs are also currently costly. Insurance coverage is spotty at best, and the drug cost can be $1000 or more monthly. In some cases, especially for patients with a much higher BMI, options like bariatric surgery may be more suitable and less costly over the long term. With FDA approval for cardiovascular disease, we expect that Wegovy will be covered, at least partly, by insurance in the foreseeable future.
As with any drug, Wegovy also has several side effects that run the gamut from mild to severe. Most patients will experience some nausea or vomiting, especially early during their medication regimen. There’s also the risk of gallbladder disease, pancreatitis, stomach paralysis, and more. Medication will have to be stopped if any of these concerns become severe.
Last but certainly not least, we expect that patients will regain their weight if they stop taking the drug and have not changed their lifestyle significantly in the meantime. When using these medications, we caution our patients to ensure they improve their diet and start an exercise program in consultation with their cardiologist to ensure that any results they achieve are sustainable and long-lasting, even if they must discontinue the medication.
Bottom Line
Approval of Wegovy for the treatment of heart disease is promising for individuals who are overweight and who have heart disease. Excess weight and obesity increase the risk for cardiovascular events and complications dramatically. Wegovy offers a treatment option to address both, which can improve long-term outcomes and quality of life. To speak to our team of doctors, please contact us today.
References:
1FDA. FDA Approves First Treatment to Reduce Risk of Serious Heart Problems Specifically in Adults with Obesity or Overweight. FDA. Published March 8, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or
2Novo Nordisk. Weight-Loss Prescription Medication | Wegovy® (semaglutide) Injection 2.4 mg. Wegovy. Published March 2024. https://www.wegovy.com/#:~:text=Wegovy
Akil L, Ahmad HA. Relationships between Obesity and Cardiovascular Diseases in Four Southern States and Colorado. Journal of Health Care for the Poor and Underserved. 2011;22(4A):61-72. doi:https://doi.org/10.1353/hpu.2011.0166