Discover the Heart-Health Benefits of Weight Loss Medications

It wasn’t long after a “new breed” of type 2 diabetes medications hit the market in the early 2000s that the public and scientists began to take note of their ability to help people struggling with weight loss to find success. Fast forward a few years later and research now shows that the benefits extend well beyond the numbers on the scale.

According to Michele Gortakowski, MD, adult and pediatric endocrinologist and Chief of Pediatric Endocrinology at Baystate Health, “For the 1 billion individuals around the world struggling with obesity and related heart conditions, GLP-1 receptor agonists are the a promising treatment option. Not only can they aid in weight loss, but studies are also showing significant benefit on heart health.”

How GLP-1 Agonists Work to Improve Heart Health

GLP-1 agonists are essentially copycat medications that mimic the naturally occurring GLP-1 hormone in your small intestine.

The release of natural GLP-1 is triggered whenever you eat. Once it’s released, it leads to reduced appetite by causing your belly to hang onto food, and it works to release insulin which lowers blood sugar levels.

By copying these effects, GLP-1 agonists suppress appetite and can contribute to significant weight loss. Patients taking the same medications for diabetes management—but under different brand names—are seeing an average weight loss of 15-20%.

Gortakowski notes, “Bringing your weight into a healthy range can have a tremendous impact on your overall health, and especially heart health. GLP1 agonists can help reduce weight, lower blood sugar and lower cholesterol levels, for example. All this can contribute to up to a 20% reduction in the risk of a serious cardiovascular event, including heart attacks and stroke.”

Is Weight-Loss Medication Right for You

The decision to go on weight-loss medication is one that should be made only after careful consideration with your doctor.

According to Gortakowski, “Generally speaking, pharmacotherapy (medications) for weight loss can be considered in those with a BMI greater than or equal to 27 mg/m2 with 1 or more obesity-related comorbidity or a BMI over 30 kg/m2 in those who failed to achieve clinically significant weight loss after 6 months of lifestyle interventions.”

However, Gortakowski notes that, “These medications are not for everyone. Like all medications, there are side effects and not everyone responds the same way. The amount of weight loss is dependent on individual factors. You should not take a weight loss medication if you're trying to get pregnant, are pregnant or are breastfeeding,. In addition, some people are unable to tolerate the side effects (detailed below).”

Understanding Your Weight-Loss Medication Options

Currently, there are six types of weight-loss drugs approved by the FDA:

• Bupropion-naltrexone (brand name Contrave)
• Liraglutide (brand name Saxenda)
• Orlistat (brand name Xenical, Alli)
• Phentermine-topiramate (brand name Qsymia)
• Semaglutide (brand name Wegovy)
• Setmelanotide (brand name Imcivree) [Note that this is approved for certain monogenic forms of obesity and has different approved indications.]
• Tirzepatide (Mounjaro)

Both liraglutide and semaglutide were initially developed as diabetes medications and, as a result, have been researched extensively. While not without side effects, these two medications are among the most well-tolerated.

Liraglutide is administered daily as an injection. The most common side effect is nausea. In some cases, vomiting may limit its use.

Semaglutide is also given by injection but on a weekly basis. Nausea and vomiting are also common side effects, as well as diarrhea, belly pain, and headaches.

While side effects do lessen for some people over time, others find them intolerable.

Potential side effects of all weight-loss medications include insomnia, constipation, nervousness, dark skin patches, depression, and even suicidal thoughts.

What to Do If You Can’t Take Weight-Loss Medication

As Kathryn Jobbins, DO, MS, FACP board certified in Internal Medicine and Obesity Medicine at Baystate Health, Associate Program Director, Internal Medicine Residency and Associate Professor of Medicine, UMass Chan Medical School-Baystate notes, “Successfully losing and keeping weight off is never about doing just one thing.

Even for those fortunate enough to be able to use a weight-loss medication, you’ve got to embrace lifestyle changes to keep it off and derive the full heart health benefits.”

No Bad Foods, Just Bad Habits

When consulting with patients, Jobbins is always quick to bust the myth that there are bad foods, particularly carbohydrates. “It’s all about moderation,” she explains. “As it turns out, our bodies need carbohydrates, fiber, protein, and even fats to maintain optimal health. It’s just about choosing the right ones.”

Jobbins is a big proponent of the U.S. Department of Agriculture’s MyPlate program. 

“My Plate provides visual cues, tips, and resources that support healthy dietary patterns. Using what’s essentially a food map, My Plate makes it easy to make gradual changes to your diet that don’t feel like punishments. You can create your own personalized eating plan based on your age, sex, height, weight, and physical activity level and choose one or two things to switch up to boost your nutritional intake.” Jobbins emphasizes, “The beauty of My Plate is that it’s less focused on what you can’t eat and more focused on what you can eat that will support your weight loss efforts. Plus, it specifically spells out which foods in what amounts you can eat every day. If you follow it, you will find success and you won’t be hungry.”

Supporting Weight Loss and Heart Health Through Movement

Another factor that contributes to weight loss success and improved heart health is exercise. Jobbins notes, “Many people hear the word exercise and immediately think ‘I can’t do that.’ But just like making dietary changes, adding exercise to your daily routine can be done through small, consistent changes. The key is to get started. If you’re not exercising regularly, set a goal to start with 10 minutes of walking a day. You don’t have to do it all at once. Five two-minute laps around the house will work. As you build strength and stamina, add more minutes to each lap, and so on. Ideally you want to get to 150 minutes per week of moderate aerobic activity but, again, don’t take on too much too fast.”

In addition to aerobic exercise, Jobbins encourages some form of strength straining. “As we age, we lose muscle mass. Strength training helps combat that and helps you retain mobility and independence later in life. And it doesn’t have to involve going to a gym. Doing squats, wall push-ups, and even just standing up and down from a chair repeatedly will build muscle, including critical heart muscle. The key is to start slow and gradually build the number of exercises you do and add new ones with a goal of eventually doing 30 minutes of strength training twice a week.”