Ozempic, Wegovy, and Mounjaro are among the most talked-about medications being prescribed for weight loss and diabetes. But patients with heart disease can also benefit from these drugs.
That‘s because losing even a small amount of weight can significantly benefit your heart health by lowering blood pressure and cholesterol levels, among other positive effects on overall health.
“Your heart doesn’t have to work as hard when you have less body weight,” says Laurette Mbuntum, MD, interventional cardiologist on the medical staff at Methodist Dallas Medical Center. “Improving heart health allows people to live longer.”
Studies have shown that GLP-1 drugs improve cardiovascular health in a range of heart patients, whether they have diabetes or not. GLP-1 is a hormone that we naturally make in our body, and its job is to increase insulin production from your pancreas and control blood sugar levels.
“The hormone was discovered in 1980, and the first medication was made over 25 years ago,” Dr. Mbuntum says. “It’s been used just for diabetes for a long time.”
Dr. Mbuntum teamed up with a group from Methodist Dallas’ new Medical Weight Loss and Wellness Program to share insights on how these drugs work and who might benefit from them.
Losing even a small amount of weight can have positive effects on cardiovascular health.
HOW GLP-1 DRUGS WORK
While GLP-1s, short for glucagon-like peptide-1 agonists, are best known for helping manage diabetes, their popularity has skyrocketed in recent years for aiding in weight loss. The medications work by signaling to your brain that you’re full, helping you feel satisfied more quickly and stay full longer because they also slow down digestion.
“Over the last 15 years, GLP-1 has been studied for weight loss,” Dr. Mbuntum says. “We saw that when patients were taking the medication, they were losing more weight than their counterparts.”
While it’s important to consult with your primary care physician, doctors say patients with risk factors for heart disease or heart failure who are motivated and willing to make long-lasting lifestyle changes are the best candidates for these medications.
Studies show that those who stop taking the medication completely are at a higher risk of gaining the weight back. At times, patients gain more weight than before because they’ve lost muscle mass, which helps burn fat. That’s why doctors encourage patients who are taking GLP-1 drugs to exercise.
“I educate the patient that this is not your solution. It helps you get there, but you have to do the work,” Dr. Mbuntum says. “You have to keep exercising, especially strength training to maintain muscle mass.”
If patients are able to do this and maintain healthy habits, they’ll see greater success while on these medications.
Doctors say patients see the best results on GLP-1s when the medication is coupled with exercise.
IMPROVING HEART HEALTH
According to Dr. Mbuntum, GLP-1s have been shown to improve cardiovascular health because obesity is closely linked to heart disease. When thinking about what makes a healthy heart, doctors narrow it down to certain key factors that every person should be aware of:
- Blood pressure: Blood pressure should ideally be around 120/70–80 mmHg, whether managed naturally or with medication. Blood pressure should be checked regularly, but at least annually at a doctor’s visit or more often at home if symptoms arise.
- Blood sugar: Blood sugar, particularly hemoglobin A1C, should also be monitored yearly, as it provides a long-term view of average blood sugar levels, especially important for those with diabetes.
- BMI: Another crucial number is body mass index (BMI), with a healthy range between 19 and 25. Values above 25 could indicate a patient is overweight, and a reading above 30 could indicate obesity. Since BMI doesn’t account for muscle mass, waist circumference is also a helpful indicator, which is ideally 40 inches or less for men and 35 inches or less for women.
- Functional capacity: Beyond numbers, functional capacity — your ability to perform daily tasks without shortness of breath or chest pain — is a major marker of heart health. This can be evaluated through an exercise stress test, where the ability to walk on a treadmill for 5–10 minutes without symptoms suggests good cardiovascular fitness.
GLP-1 medications go by many names, but the key distinction lies in whether they’re prescribed for managing diabetes or for supporting weight loss.
Are all GLP-1 medications the same?
When thinking about which GLP-1 medication to take, it’s important to keep a few things in mind.
“There are generic names and brand names, which can be confusing,” Dr. Mbuntum says. “But there are two main types of medications being prescribed for weight loss and diabetes: semaglutide and tirzepatide.”
Semaglutide is the generic name of the drug and is sold under two brand names:
- Ozempic – used primarily for diabetes.
- Wegovy – same medication but approved at a higher dose specifically for weight loss.
Tirzepatide is a different drug with two active components: GLP-1 and GIP (both hormones involved in blood sugar and appetite regulation). It’s sold as Mounjaro, originally for diabetes, but also used for weight loss because of its strong effects. Tirzepatide tends to lead to more weight loss than semaglutide because it acts on two hormones instead of just one.
There’s also a new medication in development that targets three hormones (GLP-1, GIP, and glucagon), which may be even more effective for weight loss. It’s currently nicknamed the “Triple G” drug but is still in clinical trials.
Despite all the different brand names, the key difference is in how many hormones each drug targets and what dose is approved for weight loss versus diabetes.
Consulting with your doctor can help you develop a weight loss plan that works best for you.
Making the best decision for you
While many patients trying to lose weight have had success with medications like Ozempic, Wegovy, and Mounjaro, these drugs are not a one-size-fits-all solution.
“Some patients have a lot of nausea, and it can be severe enough to cause vomiting,” Dr. Mbuntum says. “This is one of the main reasons why patients will stop the medication, but for the people who are able to tolerate those side effects, especially early on, it gets a little better.”
In addition to managing these symptoms, patients are encouraged to fully commit to a healthier lifestyle. The Medical Weight Loss and Wellness Program at Methodist Dallas is focused on helping people do just that.
Benefits of the program include physician monitoring, nutrition counseling, educational content, fitness evaluations, peer support meetings, and more. Katherine Odom, BSN, RN, CBN, nurse navigator for the program, highlights how the team is focused on helping heal the mind, body, and spirit.
“The program is all encompassing, so it includes monthly visits with a dietician, one-on-one fitness coaching, and a full-body scan,” Odom says. “The program itself isn’t medication-based, which means you don’t have to be on any weight loss medications, but if you are, then we can help monitor that.”
The first step to joining the program at Methodist Dallas is obtaining a physician referral. No matter how you choose to approach your weight loss journey, know that there are supportive options available to you.
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