A new analysis of the SELECT trial – the largest and longest clinical trial to date examining the cardiovascular benefits of semaglutide (a medication used to support weight loss and diabetes management) – confirms it also lowers the risk of major heart problems in people who are overweight or obese and already have heart disease, even if they don't have diabetes. Importantly, this heart protection happens regardless of how much weight a person loses or their baseline body weight, according to the new study, published in The Lancet.
The SELECT trial originally studied over 17,000 adults with heart disease and a body mass index (BMI) of 27 or higher, comparing semaglutide to a placebo. This new analysis looked closely at how patients' weight and waist size changed during the trial and how those changes related to cardiovascular events such as heart attacks and strokes. Researchers found that while semaglutide helped people lose weight and reduce waist size, the amount of weight lost early on didn't predict who would have fewer heart problems. However, shrinking waist size—a sign of less belly fat—was linked to better heart outcomes and accounted for about one-third of semaglutide's overall benefit.
The authors say that these findings indicate that semaglutide can offer important heart benefits that go beyond weight loss, opening the door to new ways of treating and preventing serious heart problems in people with obesity and cardiovascular disease.
