A new Lancet analysis from the SELECT trial confirms that semaglutide’s cardiovascular protection extends beyond weight loss. The study, which followed more than 17,000 adults with overweight or obesity and cardiovascular disease but without diabetes, found a 20% reduction in major cardiovascular events, independent of weight change.

Clinicians noted that baseline weight and early weight loss did not predict cardiovascular benefit, while reductions in waist circumference accounted for roughly one-third of the effect. The remaining benefit likely reflects direct disease-modifying effects of GLP-1 receptor activation—improving vascular and metabolic health independent of fat loss.

Experts say this challenges viewing GLP-1 medicines solely as “weight-loss drugs.” Even patients who lose little weight may gain heart-protective effects, supporting their use as long-term treatments for cardiometabolic disease rather than short-term weight-management tools.

Sources

• The Lancet: Deanfield J et al. Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial, published October 22, 2025.
• Florencia Halperin MD – Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements, LinkedIn, October 2025.
• Michael Albert MD – Beyond Weight Loss: Semaglutide’s Heart Benefits Go Deeper, LinkedIn, October 2025.
• Martin Haluzík MD – The reduction of cardiovascular complications by semaglutide in the SELECT trial, LinkedIn, October 2025.