A groundbreaking study published in *Cardiovascular Drugs and Therapy* has shed light on the potential impact of the weight loss drug Wegovy™ (semaglutide) on the health of over 90 million overweight or obese adults in the United States. Beyond its role in weight management, semaglutide may offer a multifaceted solution to combatting the obesity epidemic and reducing cardiovascular disease risk.
The United States faces a formidable weight management challenge, with approximately 74% of adults categorized as overweight or obese. A staggering 42% of the population falls under the category of obesity, and these numbers are expected to surge in the coming years. Obesity is closely associated with a heightened risk of cardiovascular diseases, including heart attacks and strokes, and the rising obesity rates are likely to drive an increase in cardiovascular disease cases.
Researchers and clinicians have made a remarkable discovery regarding medications originally developed to manage diabetes, such as semaglutide. These drugs can also induce significant weight loss, opening up new avenues for tackling both diabetes and obesity simultaneously.
In a clinical trial known as STEP 1, adults who were overweight or obese were given weekly doses of 2.4 mg of semaglutide, alongside lifestyle changes. The results were astounding, revealing a remarkable 14.9% reduction in body weight over a 68-week period, in stark contrast to the 2.4% reduction observed in the placebo group.
The study's findings suggest that semaglutide might offer more than just weight loss benefits. It has shown the potential to improve blood pressure, glucose levels, and lipid profiles. In addition to these findings, unpublished data from the SELECT clinical trial, supported by Novo Nordisk, suggests that semaglutide treatment in overweight or obese individuals with cardiovascular disease can reduce the risk of "major adverse cardiovascular events" by an impressive 20%.
To assess the broader impact of semaglutide on public health, researchers at the University of California, Irvine, with the support of Novo Nordisk, estimated how many adults in the U.S. could be eligible for this medication and the potential effect on obesity and cardiovascular disease.
Using the eligibility criteria from the STEP 1 clinical trial, the researchers estimated that a staggering 93 million U.S. adults could benefit from semaglutide treatment, potentially preventing 43 million individuals from being classified as obese.
Further analysis involving around 83 million individuals without pre-existing cardiovascular disease revealed a 1.8% reduction in the 10-year risk of cardiovascular disease. This reduction, from 10.15% to 8.34%, constitutes a relative reduction of 18%. Such an outcome could potentially prevent up to 1.5 million cardiovascular events in a decade. While the study did not estimate the number of events prevented among the approximately 10 million individuals with pre-existing cardiovascular disease, the implications are clear.
Professor Nathan D. Wong, lead author of the study and director of the Heart Disease Prevention Program at the University of California, Irvine, described this breakthrough as "one of the biggest advances in the obesity and cardiovascular medicine world." Semaglutide presents a unique opportunity to not only manage weight but also significantly reduce cardiovascular events, extending its potential benefits beyond the diabetic population it was initially studied in. It could be a vital consideration for individuals who are obese or overweight and have other risk factors, especially when cardiovascular disease is their leading cause of disability and death.
Despite its promising potential, the cost of therapies like semaglutide remains a significant hurdle, making them inaccessible to many individuals, especially given the challenges in drug supply due to high demand. It's essential to note that weight management drugs like semaglutide can have side effects, emphasizing the importance of combining them with dietary and physical activity interventions for comprehensive weight management and cardiovascular disease risk reduction.
Professor Wong underscores the necessity of improving access to these therapies, particularly for high-risk, underserved populations that stand to benefit from such treatments. As the fight against obesity and its associated cardiovascular risks continues, semaglutide offers hope and potential solutions on a grand scale.
Reference:
Wong, N.D., Karthikeyan, H. & Fan, W. US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events. Cardiovasc Drugs Ther (2023). https://doi.org/10.1007/s10557-023-07488-3