Are Ozempic, Mounjaro, Wegovy, and Similar Drugs Good for Your Heart Health?
If you’ve been following the news lately, you’ve probably seen much coverage on using OzempicTM, a diabetes drug approved in 2017 by the FDA, and WegovyTM (with the same active ingredient), approved in 2022 for certain obese patients. These drugs, and others like MounjaroTM and RybelsusTM, have been in such high demand that we are experiencing the effects of production shortfalls. Notably, while Ozempic and Mounjaro are diabetes drugs, they can still be prescribed “off-label” by qualified physicians and clinicians.
Let’s discuss whether these drugs make sense for a patient concerned about heart disease, and in doing so, we will focus on the two drugs (both Semaglutides) that have garnered the most headlines – Ozempic and Wegovy. Ozempic has apparent positive effects on type-2 diabetes by reducing blood sugar levels through improved insulin sensitivity in type two diabetics. While taking the drug, most patients ate less and lost weight, leading the developer to seek FDA approval for a new higher-dose indication as a weight loss therapy – Wegovy was brought to market last year.
Due to a viral social media trend, patients who do not qualify for these drugs have been receiving these prescriptions off-label, thus contributing to the significant shortages we have seen of late. Of course, we are concerned about the lack of these drugs because of their therapeutic importance for those suffering from type two diabetes or obesity; however, do these drugs work, and are they good for the heart?
The short answer is that they can be very effective in the right circumstances and for suitable patients.
On the one hand, metabolic diseases, including high blood pressure, hypertension, and type two diabetes, are critical precursors and risk factors for coronary heart disease. And these drugs, known as GLP-1 agonists, work both in the brain and the gut to give patients a sense of satiety and make them less hungry, improving many of the underlying concerns that lead to heart disease. On the other hand, losing weight alone also has downsides if not appropriately managed. First, there is a tendency to overdo it and not consume sufficient calories to maintain proper health. For many, this means losing significant muscle mass and becoming colloquially known as “skinny fat.” In other words, there may be considerable weight loss, but the patient may not be burning enough of the bad visceral or white fat and instead are losing muscle, which can lead to skeletal issues, like osteoporosis, in the future.
We are also concerned about patients who do not use their time losing weight to implement permanent lifestyle changes to take advantage. Ultimately, if the drugs are ever discontinued, and solid diet and exercise habits are not in place, patients may regain the weight they lost and put on even more – much like many do after a significant diet.
What’s The Answer
If you have type two diabetes or are suffering from obesity and qualify for either of these drugs, you may wish to speak to your primary care physician, your cardiologist here at Nevada Cardiology, or your endocrinologist to learn more about whether medical weight loss using prescription drugs is the best way forward. While these medications have side effects, they are generally safe when used appropriately and may lessen the often-greater risks of heart disease. Your doctor will work with you to understand if the risk associated with your metabolic diseases and potential future or existing heart disease is greater than the risk of taking the medication.
Further, exercising and eating correctly are essential to maintaining good muscle mass, which can avoid skeletal concerns like joint problems and osteoporosis. Consuming the appropriate nutrients and maintaining muscle mass also helps continue calorie burn even after eventually stopping the medication. In other words, you’ll have a better chance of keeping the weight off if you maintain your muscle mass than if you lose weight from diet alone. If you start these medications, be sure to speak to your doctor about an appropriate exercise regimen that includes resistance exercise.
Lastly, we need to learn more about the long-term effects of these drugs and if they are sustainable and effective years down the road.
While on the surface, the decision may seem like a no-brainer, it’s crucial that you have an open and honest discussion with your medical team about the best ways to reduce your risk of worsened cardiovascular problems due to excess weight or diabetes. While these drugs are a watershed moment and wait and diabetes management, every therapy comes with risk, so be open to discussing it with us at a consultation.