The decision to prescribe the weight loss drug Wegovy (semaglutide) to NHS patients for preventing heart attacks and strokes has been hailed as a 'major turning point in the battle against obesity' by experts. The National Institute for Health and Care Excellence (Nice) has approved semaglutide for overweight and obese patients with certain heart and circulatory conditions to reduce their risk of major cardiovascular events.
Professor Naveed Sattar of the University of Glasgow described the move as a 'genuine win–win', noting that these medicines not only reduce heart attacks, strokes, and peripheral arterial disease but also lead to meaningful weight loss, improving patients' quality of life. He stressed that addressing weight directly is essential for delivering the best outcomes for patients with cardiovascular disease.
However, experts have urged caution regarding side effects. Professor Robert Storey of the University of Sheffield highlighted that GLP-1 receptor agonists can reduce muscle mass as well as fat, so physical activity, particularly resistance training, is important to counteract potential negative effects on muscle strength. This may not be feasible in frail patients, and the benefits must be balanced against the risk of side effects.
Professor Riyaz Patel of UCL called on health leaders to ensure equitable access, warning of a potential postcode lottery in care. He noted that other highly beneficial drugs have been variably delivered, exacerbating health inequalities, and urged integrated care boards to avoid this with the new Nice guidance.
Huw Edwards, chief executive of ukactive, emphasised that while the medication can be transformative, it is not a standalone solution. He stressed that treatment should be combined with structured physical activity and wider lifestyle support to ensure sustainable results and prevent muscle loss.
