Semaglutide drugs like Ozempic help with weight loss and heart health

Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist found in drugs such as Ozempic, Rybelsus and Wegovy, has significant benefits for people with obesity and other weight control problems, according to two new studies. p>

One study, published in Nature Medicine, included 17,000 adults without diabetes who were classified as overweight or obese.

The study found that taking semaglutide-based drugs led to an average reduction in body weight of 10% and a decrease in waist circumference of more than 7 centimeters (2.7 inches) over a four-year period.

"Weight loss strategies have been transformed with the introduction of GLP-1... Compared to previous weight loss approaches," Dr. Luke Twelves, medical director of research company Lindus Health, who was not involved in the study, told Medical News Today. "This study adds data to our understanding of the potential roles of GLP-1 and strengthens the case for its inclusion earlier in treatment."

The study, led by Dr. Donna Ryan of the Pennington Biomedical Research Center in New Orleans, also found that more than half of the participants lowered their body mass index (BMI) category by at least one category after two years of taking semaglutide (compared to 16% in placebo group), and 12% achieved a healthy BMI (compared to 1% in the placebo group).

“Such sustained weight loss is rarely seen in clinical trials of other weight loss methods,” Michelle Rautenstein, a preventive cardiology nutritionist at EntirelyNourished.com, who was not involved in the study, told Medical News Today.

She added that “waist circumference was measured because it specifically targets abdominal weight, which is strongly associated with inflammation and heart disease risk.”

Antoni Adamrovich, chief medical officer and co-founder of the weight-loss program Tb2.health, who was not involved in the study, said the study showed GLP-1 drugs to be significantly more effective than other popular weight-loss drugs. Other weight loss medications, such as phentermine or naltrexone/bupropion, are associated with an average weight loss of 3-7%.

GLP-1 drugs such as Ozempic and heart health

A related study by researchers at University College London found that GLP-1 drugs used to treat type 2 diabetes and promote weight loss also had cardiovascular benefits, regardless of how much weight people lost or what their starting weight was.

While that study, which has not yet been published in a peer-reviewed journal, did not include people with diabetes, “it’s likely that semaglutide will produce similar results in people with diabetes,” Rautenstein said. “This is because semaglutide primarily functions by mimicking the actions of the natural incretin hormone GLP-1 to slow the absorption of food, providing greater feelings of fullness and controlled blood sugar metabolism.”

Positive results were seen across all genders, races, ages, regions and body sizes compared with placebo, the researchers reported.

“Our long-term analysis of semaglutide shows that clinically meaningful weight loss can be maintained for up to four years in a geographically and racially diverse population of adults who are overweight and obese but do not have diabetes,” Ryan said in a press release. “These weight reductions in such a large and diverse population suggest that it may be possible to impact public health by reducing the burden of multiple obesity-related diseases. While our study focused on cardiovascular events, many other chronic diseases, including several types of cancer, osteoarthritis, and anxiety and depression, could benefit from effective weight management.”

John Deanfield, professor of cardiology at University College London, who led the companion study, added that the results show that semaglutide “has other actions that reduce cardiovascular risk beyond reducing unhealthy body fat.”

“These alternative mechanisms could include positive effects on blood sugar, blood pressure or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these factors,” he said.

Side effects of semaglutide treatment can include gastrointestinal symptoms such as nausea and diarrhea, and an increased risk of gallstones. However, the researchers said that negative symptoms were actually lower in semaglutide recipients than in the placebo group.

The results were presented at the European Congress on Obesity in May 2024.

The data were from the ongoing Semaglutide and Cardiovascular Outcomes (SELECT) study, which began in 2018. In 2023, a study using SELECT data in a similar population showed that taking semaglutide for more than three years reduced the risk of heart attack, stroke, and cardiovascular death by 20%.

Adamrovich said additional studies showing the effects of GLP-1 treatment over more than four years would be useful "to see whether the long-term benefits of weight loss and improved cardiovascular health are maintained."

“Follow-up studies focusing on some cardiovascular diets and moderate exercise combined with the use of semaglutide or tirzepatide would also be useful,” he added.