Fast Facts
Sustained Weight Loss: Wegovy users maintained a 10% body weight reduction over four years
Heart Health: Participants had a 20% lower risk of major cardiovascular events
Adverse Events: Fewer serious adverse events, though gastrointestinal symptoms were common
Demographic Consistency: Effective across various demographics and health conditions.
Recent analyses of the longest clinical trial for the weight-loss drug Wegovy have provided new insights into its effectiveness. The findings suggest that Wegovy can help sustain weight loss for up to four years and improve heart health, regardless of the amount of weight lost.
Weight Loss and Heart Health
A study found that participants taking Wegovy, which contains the active ingredient semaglutide, sustained a 10% reduction in body weight over four years. Another analysis revealed that Wegovy users experienced improvements in heart health, independent of weight loss. These analyses are based on data from the SELECT trial, which involved 17,604 non-diabetic individuals with cardiovascular disease and obesity or overweight. Participants were randomly assigned to receive either a placebo or weekly injections of Wegovy.
Clinical Implications
John Deanfield, a professor of cardiology at University College London and leader of the study, emphasized the clinical importance of these findings. He noted that many patients in cardiovascular practices could benefit from semaglutide alongside their usual care.
Effectiveness Over Four Years
Researchers followed the participants for four years, twice as long as previous studies. They reported in the journal Nature that Wegovy users continued to lose weight for an average of 65 weeks. By two years, 12% of those on semaglutide achieved normal weight status, and over 55% no longer qualified as obese, both significantly higher than the placebo group.
Long-term Weight Management
By the end of 208 weeks, participants had reduced their waist circumference by an average of three inches and maintained a 10% reduction in body weight. Weight loss was consistent across various demographics, including sex, race, body size, location, age, and preexisting health conditions. Donna H. Ryan, MD, a study author and professor emerita at Pennington Biomedical Research Center, noted that weight loss with Wegovy was robust but slightly less than previous studies due to not pushing the doses to the maximum in all cases.
Adverse Events and Continuation
The trial revealed fewer serious adverse events in Wegovy users compared to the placebo group. However, gastrointestinal symptoms like nausea and diarrhea led more Wegovy users to leave the study. The study did not address whether participants regained weight after stopping Wegovy, highlighting the need for further research into weight maintenance strategies.
Heart Benefits Beyond Weight Loss
In 2023, SELECT trial results showed a 20% lower risk of major adverse cardiovascular events, such as heart attacks and strokes, among participants. This led the FDA to approve Wegovy for reducing cardiovascular risks in adults with cardiovascular disease and obesity, in addition to its previous approval for chronic weight management.
Mechanisms of Cardiovascular Benefits
A separate analysis presented at the European Congress on Obesity indicated that heart health benefits were independent of the amount of weight lost. This suggests that factors other than fat reduction, such as improvements in blood pressure, blood sugar, or inflammation, might contribute to better cardiovascular outcomes. Carlos Sanchez, MD, an expert in cardiovascular disease at OhioHealth Heart & Vascular, suggested that these mechanisms deserve further exploration.
Study Limitations
Sue Decotiis, MD, a New York City weight-loss physician, pointed out that the study did not mention the medications participants were taking, which could influence results. Additionally, the participant pool lacked diversity, making it difficult to generalize Wegovy’s impact across different populations.
The findings from the SELECT trial offer promising evidence for the long-term effectiveness and cardiovascular benefits of Wegovy. While the results are significant, further research is needed to understand weight maintenance strategies and the diverse impacts on different populations. These insights are crucial for developing comprehensive treatment plans for individuals struggling with obesity and related health conditions.
Summary
Wegovy (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist that mimics the hormone GLP-1, which helps regulate appetite and food intake. By influencing these processes, Wegovy aids in weight reduction and management.
Future Research Directions
Future studies should focus on long-term weight maintenance post-treatment and the exploration of additional cardiovascular benefits mechanisms. Understanding how to sustain weight loss after discontinuing Wegovy is critical for long-term health outcomes.