Weight Loss Drug Could Benefit Over 90 Million US Adults

A new study suggests that over 90 million US adults that are overweight or obese may benefit from the weight loss drug Wegovy™ (semaglutide). The research is published in Cardiovascular Drugs and Therapy.

The success of weight management drugs

Approximately 74% of US adults are overweight or obese, with 42% classified as obese – rates that are expected to rise. Obesity’s link with increased risks of cardiovascular diseases such as heart attack and stroke is well documented, and rising rates of obesity will likely lead to a rise in cardiovascular disease.

Researchers and clinicians have discovered that new medications to control diabetes, such as semaglutide, can also benefit patients by inducing weight loss.

A clinical trial (STEP 1) of adults who were overweight or obese showed that weekly doses of 2.4 mg semaglutide or a placebo – both alongside lifestyle changes – resulted in a 14.9% reduction in bodyweight over a 68-week period, compared to 2.4% in the placebo group.

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But the benefits may not stop at weight loss – the study’s findings also indicate that these drugs can improve blood pressure, glucose levels and lipid levels. Unpublished data from the SELECT clinical trial, announced by Novo Nordisk, also suggest that semaglutide treatment for overweight/obese people with cardiovascular disease reduced the risk of “major adverse cardiovascular events” by 20%.

To investigate this further, the researchers from the University of California, Irvine, supported by semaglutide’s manufacturer – Novo Nordisk – estimated how much of the US population could be eligible for this medication and assessed the possible impact this could have on obesity and cardiovascular disease.

Potential to prevent cardiovascular events

Using eligibility criteria from the STEP 1 clinical trial, researchers estimated that 93 million US adults would be suitable for semaglutide treatment, postulating that this could result in 43 million fewer people being classified as obese.

Using data from around 83 million of this study population who did not have pre-existing cardiovascular disease, the team next estimated that a 1.8% reduction in 10-year cardiovascular disease risk (from 10.15% to 8.34, a relative reduction of 18%) could prevent up to 1.5 million cardiovascular events in 10 years. However, they did not estimate the number of events prevented from treatment among the approximately 10 million of those with pre-existing cardiovascular disease.

“It is one of the biggest advances in the obesity and cardiovascular medicine world,” said Professor Nathan D. Wong, lead author of the study and director of the Heart Disease Prevention Program at the University of California, Irvine. “We now have a weight control therapy that also significantly reduces cardiovascular events beyond the diabetes population where it was originally studied. It should be considered for patients who are obese or overweight with other risk factors where cardiovascular disease is their leading cause of disability and death.”

Accessibility is key

The costs of these therapies remain significant, rendering them inaccessible to many people, particularly as the supply of drugs such as semaglutide have been fraught with problems due to intense demand.

It is important to note that this type of weight management drug can come with side effects and that dietary and physical activity interventions should form the basis of weight management and cardiovascular disease risk reduction.

Finally, Wong emphasizes that, given their costs, improved access to these therapies is required for high-risk, underserved populations that may benefit from treatment.

Reference: Wong ND, Karthikeyan H, Fan W. US Population eligibility and estimated impact of semaglutide treatment on obesity brevalence and cardiovascular disease events. Cardiovasc. Drugs Ther. 2023. doi: 10.1007/s10557-023-07488-3

This article is a rework of a press release issued by the University of California, Irvine. Material has been edited for length and content.