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Weight management drugs: a new frontier in cardiovascular health
07/24/2025
How diabetes medications are reshaping weight loss and revolutionizing heart health care.
By: Benjamin Schaefer, MD, cardiologist at Nuvance Health, part of Northwell Health
In recent years, several medications, which were originally developed for diabetes, have emerged not only as tools for weight management but also as powerful allies in the fight against cardiovascular disease. Obesity is now affecting over 40 percent of U.S. adults, as well as an increasing number of children, and contributing to many chronic conditions such as diabetes and hypertension.
These drugs, commonly referred to as GLP-1 (and GLP-1/GIP) agonists, are now also reshaping how clinicians approach heart health. The most used drugs are semaglutide (Ozempic/Wegovy) and tirzepatide (Zepbound/Mounjaro), but older medications are still on the market and many others are being developed.
Related Content: Tirzepatide or semaglutide, weight loss drugs explained
Who should consider these medications?
The new class of weight management drugs are typically recommended for:
- Adults and children with Type 2 diabetes
- Adults with a BMI ≥30, or ≥27 with weight-related conditions like hypertension, type 2 diabetes or high cholesterol
- Adolescents aged 12 and older with severe obesity, depending on the medication
- Individuals who have struggled to lose weight through lifestyle changes alone
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How do these drugs improve cardiovascular health?
GLP-1 agonists work through various mechanisms — appetite suppression, hormonal regulation, improved insulin sensitivity and decreasing inflammation. Their cardiovascular benefits include:
- Decreasing risk of major adverse cardiovascular events, such as heart attack and stroke
- Improving symptoms and cardiac events in heart failure
- Through weight loss affecting risk factors for heart disease such as improved insulin sensitivity, reduced inflammation and increasing ability to exercise.
Related content: The connection between diabetes and heart disease
What are the risks and side effects
While generally well tolerated, these medications are not without risks:
- Gastrointestinal issues: nausea, vomiting, constipation, diarrhea, gallbladder and pancreatic disease
- Mood changes or suicidal thoughts: noted in some cases, requiring monitoring
- Allergic reactions
- Low blood sugar (rare, but especially in combination with other medications)
- Dehydration and kidney injury
- Possible visual problems
Learn more about weight loss support.
What are the benefits beyond the scale
Even modest weight loss — 5 to 10 percent of body weight — can lead to:
- Improved blood sugar control
- Reduced visceral fat, which is strongly linked to cardiovascular risk
- Remission of type 2 diabetes
- Better sleep and reduced sleep apnea
- Lower risk of 14 types of cancer, including those affecting the heart and lungs
Weight loss seen with a GLP-1 agonist can be up to 20 to 25 percent, and sometimes more. These benefits are amplified when medications are combined with lifestyle interventions, such as diet, exercise and behavioral therapy.
Related content: Explore new ways to bolster heart health
What questions should I ask my doctor about weight management medications?
Talking with your doctor about weight management medication is an important step toward making an informed, personalized decision. Here are some thoughtful questions that can help guide the conversation:
Learn more about preventive cardiology at Nuvance Health
Understanding your options
- What weight management medications would be most appropriate for my health history and current needs?
- How do these drugs compare in terms of effectiveness, side effects and long-term outcomes?
- Are any medications contraindicated based on my conditions (history of pancreatitis, rare cancers)?
Evaluating risks and benefits
- What benefits can I expect beyond weight loss — especially for my heart health or other risk factors?
- What are the most common side effects and how can they be managed?
- Are there rare but serious risks I should be aware of, like pancreatitis or gallbladder issues?
Monitoring and follow up
- How frequently will I need follow-up appointments, lab tests or screenings?
- What signs should I watch for that might indicate a problem?
- Can I stop the medication if I don’t tolerate it well — and how should that be done safely?
Combining with lifestyle changes
- What lifestyle adjustments should I make alongside the medication?
- Will I have access to support like nutrition counseling or behavioral therapy?
Cost and insurance coverage
- Is the medication covered by my insurance?
- If not, are there affordable options, patient assistance programs or alternative treatments that could be more cost-effective?
Long-term planning
- How long would I likely stay on this medication?
- Is this intended as a lifelong treatment or a temporary aid?
- What happens if I reach my goal weight — do I continue taking it?
You might also bring a medication list, recent lab results and info on any prior weight loss attempts — it helps paint a clearer picture.
Learn more about the Heart and Vascular Institute at Nuvance Health
The bottom line: Weight management medications are no longer just about shedding pounds — they’re about saving lives. For individuals at high cardiovascular risk, these medications offer a scientifically backed, increasingly accessible path to better health. As research evolves and access improves, they may become a cornerstone of preventive cardiology.
If you’re curious whether these treatments are right for you, it’s best to consult a healthcare provider who can tailor a plan based on your medical history, goals and insurance coverage.