Wegovy can cut the risk of heart attack and stroke

A long-term clinical trial found that the weight loss medication Wegovy may reduce the risk of cardiovascular events, such as heart attack and stroke, by as much as 20%, according to the drug’s manufacturer, Novo Nordisk. 

These findings could mean big things for people who take Wegovy, including a reduced cardiovascular risk and potentially even cost-savings — since some insurers are more likely to cover heart medications than weight loss drugs.

Wegovy is one brand name of the medication semaglutide and is FDA-approved to treat obesity when used in combination with a reduced-calorie diet and increased physical activity. It may be prescribed to people with obesity (defined as a body mass index, or BMI, of 30 or higher) or people who have a BMI of 27 or higher and a weight-related condition such as high blood pressure, high cholesterol, or type 2 diabetes.

Wegovy is injected once a week under the skin of the upper arm, thigh, or abdomen. The most common side effects of Wegovy include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

Wegovy is part of a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. These medications work by mimicking GLP-1, a gut hormone involved in insulin secretion and appetite control. GLP-1 medications like Wegovy slow gastric emptying (or how quickly food travels along your digestive system), so food takes longer to leave your stomach, making you feel full sooner and for longer. They also send signals to the brain that you’re full, and may even influence which foods you find palatable, further reducing your appetite and leading to weight loss. 

In clinical trials, people taking Wegovy lost nearly 15% of their body weight, on average, within a year and a half of starting treatment. On its own, this amount of weight loss can improve a range of chronic conditions and several cardiovascular risk factors, including lowering elevated blood pressure and reducing lipid levels. However, Wegovy had not been shown to directly reduce major cardiovascular events (like heart attack and stroke) until these most recent findings from the SELECT trial.

Wegovy contains the same active ingredient, semaglutide, as Ozempic, a diabetes medication that may be prescribed off-label for weight loss. Ozempic is intended for people with type 2 diabetes. It treats both high blood sugar, and, in people who have both type 2 diabetes and established heart disease, reduces the risk of experiencing a major cardiovascular event. Clinical trials have found that Ozempic reduces cardiovascular risk by as much as 26% among people with type 2 diabetes and heart disease.

In August 2023, Novo Nordisk announced that Wegovy reduced the risk of a major cardiovascular event — including heart attack, stroke, or death — by 20%. The clinical trial involved over 17,600 adults aged 45 and up with overweight or obesity and established heart disease, but no diabetes. The findings are a big deal because they’re the first to confirm that Wegovy can do more than help with weight loss.

These results are in line with other research that has found cardiovascular benefits from similar medications, including other GLP-1 receptor agonists like Ozempic and Saxenda, as well as stimulants like phentermine. These benefits may include reductions in blood pressure, overall cholesterol, triglycerides, and LDL (or “bad”) cholesterol.

We still don’t know all the details of the clinical trial, including the risk breakdown by individual, amount of weight lost, or the prevalence of side effects — just that Wegovy was safe and well-tolerated, which we know from previous clinical trials. The findings have yet to be published in a peer-reviewed journal or reviewed by anyone outside of the company, for that matter. Novo Nordisk plans to release the full findings later this year.

Based on the results of this clinical trial, Novo Nordisk plans to ask the U.S. Food and Drug Administration to add cardiovascular benefits to the prescription label for Wegovy later this year.

“We don't know the mechanism yet by which [Wegovy] reduces cardiovascular risk,” shared Dr. Beverly Tchang, an endocrinologist who treats patients with obesity, and an advisor to Ro. “It might be driven by weight loss or by more direct mechanisms like improvements in blood vessel function.”  

Heart disease is the leading cause of death for men and women globally, while the number of people with overweight or obesity has nearly tripled in the last fifty years. Risk factors for heart disease include obesity, high blood pressure, high cholesterol, diabetes, and smoking. Obesity increases the risk of high blood pressure, high cholesterol, type 2 diabetes, stroke, some cancers, and the chance of dying from heart attack or stroke — which are the leading causes of death among people with obesity. 

Weight loss can help with both heart disease and obesity, as well as a range of conditions that include polycystic ovarian syndrome (PCOS), infertility (by restoring ovulation through weight loss in people with PCOS), type 2 diabetes, sleep apnea, and non-alcoholic fatty liver disease. “Weight loss of just 5% has been shown to improve cholesterol, blood pressure, and blood sugar,” shared Dr. Tchang. “Higher amounts of weight loss can even fully treat diabetes or fatty liver disease.”

Despite the growing, overwhelming evidence of obesity as a disease (and the American Medical Association officially recognizing it as such a decade ago), there is still a misconception of weight loss medications as “vanity drugs.” 

As a result, insurance companies don’t always consider these medications medically necessary, and won’t provide coverage. In particular, Medicare Part D does not provide coverage for weight loss medications, but it’s also possible that private insurance plans may not cover drugs like Wegovy.

With Wegovy’s average list price of $1,349.02 for a month’s supply, this lack of insurance coverage can put the medication out of reach for many of the people who need it. 

“We hope to see better coverage for Wegovy since insurance companies have historically taken heart medications more seriously, though in reality, we're finding Wegovy to be an all-around metabolism medication with multiple benefits,” shared Dr. Tchang. 

For now, we’ll have to wait and see. Once the full findings from the clinical trial are published, we’ll know more about what change — if any — these heart benefits may have on insurance coverage for Wegovy. In the meantime, people can save on Wegovy by price-shopping at different pharmacies, and taking advantage of Patient Assistance Programs and the Wegovy savings card if they’re eligible.

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Current version

August 30, 2023

Written by

Amelia Willson

Fact checked by

Yael Cooperman, MD

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About the medical reviewer

Yael Cooperman, MD, Ro

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.