American College of Cardiology now supports early use of medication to treat obesity
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The American College of Cardiology (ACC) is embracing, more than ever before, the cardiovascular benefits of weight loss medications such as semaglutide and tirzepatide.
Previous recommendations stated that patients should try exercise and other lifestyle interventions to lose weight before choosing pharmaceutical solutions. Now, however, the ACC is recommending that cardiologists and other healthcare providers consider these medications as a first-line treatment option for eligible patients.
This updated perspective is one of many takeaways from a new ACC guidance published in the Journal of the American College of Cardiology.[1]
“Patients should not be required to ‘try and fail’ lifestyle changes prior to initiating pharmacotherapy; nonetheless, lifestyle interventions should always be offered in conjunction with obesity medications,” Olivia Gilbert, MD, MSc, chair of the new guidance and a cardiologist at Atrium Health Wake Forest Baptist Medical Center, said in a statement.
Co-authors include Martha Gulati, MD, a cardiologist with Cedars-Sinai and known leader in the field of protective cardiology, as well as physicians from a variety of other specialties.
Semaglutide and tirzepatide
The rising popularity of weight management drugs—among clinicians as well as patients—has been one of modern healthcare’s biggest trends. Semaglutide and tirzepatide are perhaps the two most popular weight loss medications used for this purpose. They were both originally developed as diabetes drugs, but they are being used more and more for weight loss and other health benefits.
Semaglutide is a GLP-1 receptor agonist sold by Novo Nordisk under the brand names Wegovy and Ozempic. It has been associated with a long list of health benefits, including several associated with improvements in cardiovascular symptoms in patients with and without diabetes.
Tirzepatide, meanwhile, is a popular dual GIP/GLP-receptor agonist sold by Eli Lilly and Company under the brand names Zepbound and Mounjaro. It has previously been linked to improved outcomes in patients with sleep apnea and heart failure with preserved ejection fraction.
The authors of the new guidance emphasized that semaglutide and tirzepatide have both been shown to be highly effective when it comes to helping patients lose weight and reduce their risk of cardiovascular disease. Tirzepatide has been linked to slightly more weight loss in some studies, they wrote, but choosing from one or the other is going to likely be dictated more by insurance coverage and drug availability than the potential to lose a few extra pounds.
Other key details to consider
The new ACC guidance details the clinical decision-making process clinicians should follow when considering treatment plans for their patients. It is important to ensure a patient is eligible for one of these drugs, for example, and availability and affordability are two key areas that always need to be considered.
Another focus of the document is the fact that team-based approaches are recommended when guiding the care of a patient. Instead of a single cardiologist going with their gut, in other words, treatment decisions should be made with input from a variety of sources.
“Weight management by the cardiovascular community needs to be embraced, given both the prevalence of obesity and the impact it has on many forms of CVD,” Gilber said in the same statement.
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.