The weight-loss drug semaglutide – best known under the brand name Wegovy – reduces the risk of heart attack, stroke, or heart-related death regardless of how much weight a person loses, according to new research published in The Lancet.
The large-scale SELECT trial, led by University College London (UCL), studied 17,604 adults aged 45 and over who were overweight or obese across 41 countries. Participants were randomly assigned weekly injections of semaglutide or a placebo.
Researchers found that semaglutide cut major cardiovascular events by 20%, even in those who lost little or no weight. The results suggest the drug’s benefits go beyond weight loss alone, possibly improving heart health through other biological pathways.
However, a reduction in waist size, rather than overall weight, was linked to stronger heart benefits, accounting for about one-third of the drug’s positive cardiovascular effects.
Lead author Prof John Deanfield said: “Abdominal fat is more dangerous for our cardiovascular health than overall weight, but two-thirds of semaglutide’s heart benefits remain unexplained. This reframes it from being just a weight-loss jab — it’s a drug that directly impacts heart disease.”
He added that the findings challenge current prescribing limits: “You don’t need to lose a lot of weight or have a high BMI to gain heart benefits. Restricting its use to only the most obese patients doesn’t make sense.”
Experts cautioned that while semaglutide’s advantages are significant, further study is needed to assess long-term side effects and safety as use expands to a broader population.
