GLP-1 Antagonists: Losing Weight Can Be Good for your Heart

The immense popularity of GLP-1 agonists for weight loss and management of diabetes has highlighted the benefits of weight loss including reduction of cardiac risk.

What is a GLP-1 Agonist?

The class of medications called GLP-1 agonists, including semaglutide (Ozempic or Wegovy) and tirzepatide (Mounjaro and Zepbound), are compounds similar to a naturally occurring hormone in the body called glucagon-like peptide-1.  When these medications bind to the receptor in the brain, gut and pancreas, they trigger a number of potentially beneficial effects.

How does a GLP-1 Agonist work?

GLP-1 agonists work through a number of mechanisms:

1.     Increasing insulin release to lower blood sugar

2.     Delaying stomach emptying that makes one feel fuller for a longer period of time

3.     Stimulating the hypothalamus that triggers an earlier feeling of being full while eating 

Overall, these effects result in consumption of less calories, and weight loss.  Furthermore, with reduction of weight, studies have shown a reduced risk of heart disease including heart attack.  Other benefits may include reduced craving for alcohol.

Are There Any Studies for Heart Benefits for GLP-1 Agonists?

A number of studies have demonstrated a benefit at reducing the risk of cardiac events including heart attack, stroke, cardiac death as well as improvement for certain patients with congestive heart failure. Additional benefits for may include improvement in blood pressure and cholesterol levels that can lower long term risk of serious cardiac disease.  Weight loss with use of GLP-1 or in general may also improve the severity or eliminate obstructive sleep apnea, therefore reducing stress on the heart.

Are GLP-1 Agonists Safe to Use?

With all medications, there are potential risks and benefits.  When considering a new medication, it is important to discuss with a medical professional all of the risks and benefits prior to starting any medication.  The GLP-1 agonist class of medications can cause nausea, vomiting, diarrhea, halitosis (bad breath), abdominal pain. More serious effects can include gastroparesis (permanent slowing of stomach emptying), bowel obstruction, macular edema causing vision loss, pancreatitis, kidney injury, gallstones, thyroid tumors.