The weight-loss drug semaglutide—the active ingredient in Wegovy—can significantly reduce the risk of heart attack or stroke 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, followed 17,604 overweight or obese adults aged 45 and over across 41 countries. Participants were given either weekly semaglutide injections or a placebo. Results showed that semaglutide cut the risk of major cardiac events by 20%, including heart attacks, strokes, and heart disease deaths.
Researchers found that the heart benefits were independent of overall weight loss, suggesting the drug improves cardiovascular health through multiple mechanisms. However, reductions in waist circumference, a key marker of abdominal fat, accounted for about one-third of the observed heart benefits.
Lead author Prof John Deanfield said abdominal fat poses a higher risk to heart health than total body weight. “This still leaves two-thirds of the heart benefits unexplained,” he noted. “Semaglutide is more than a weight-loss jab—it directly affects heart disease and other conditions of ageing.”
The findings challenge current prescribing guidelines that limit semaglutide use to patients with high BMI. Deanfield said even people with moderate weight or average BMI could gain heart-protective effects. However, he cautioned that potential side-effects must be carefully weighed as the drug’s use expands.
