Analysis finds Wegovy heart benefit appeared before major weight loss
The finding suggests semaglutide's heart protection is not only a result of weight loss, though key details of the analysis have not yet been disclosed.
An analysis of the SELECT trial found that the reduction in cardiovascular events seen with Wegovy (semaglutide) showed up early in treatment, before patients had lost a clinically meaningful amount of weight, Novo Nordisk said on May 13, 2025 [1].
The result supports the idea that semaglutide's heart benefit is not only a consequence of weight loss [1].
What the analysis looked at
SELECT is the trial that first tied Wegovy to heart protection. In August 2023, Novo Nordisk reported that semaglutide 2.4 mg reduced the risk of major adverse cardiovascular events by 20 percent in adults with overweight or obesity [1]. Those results were presented on November 11, 2023, at the American Heart Association Scientific Sessions and published at the same time in the New England Journal of Medicine [1].
Major adverse cardiovascular events, as defined on the Wegovy label, are cardiovascular death, non-fatal heart attack, or non-fatal stroke [1]. On March 8, 2024, the FDA approved Wegovy to reduce the risk of those events in adults with established cardiovascular disease and either obesity or overweight [1].
The new analysis is about timing rather than the overall 20 percent figure [1]. How early the event reduction appeared — weeks or months into treatment — has not been disclosed, nor has the size of the early reduction, the definition of clinically meaningful weight change, or where the analysis was presented or published [1]. Wegovy was first approved on June 4, 2021, for weight management in adults with obesity [1].
Why it matters for patients
Wegovy's cardiovascular approval is not tied to how much weight a patient loses. The indication covers adults with established cardiovascular disease plus obesity or overweight, and it rests on the results of the overall SELECT trial, not on a weight threshold [1]. If the heart benefit begins before substantial weight loss, that would suggest the drug's cardiovascular effect and its weight effect are not entirely one and the same. The information released so far does not establish that, and the early-period numbers have not been reported [1].
For patients who lose little weight on the drug, or who stop it early because of side effects, the timing question is also practical. The announcement does not say whether the early benefit held up for people who stayed on treatment [1]. Nausea, diarrhea, vomiting, constipation and abdominal pain are among the common side effects listed for Wegovy, appearing in at least 5 percent of adults or children aged 12 and older [1]. The label also carries a boxed warning for an increased risk of thyroid C-cell tumors, along with warnings for pancreatitis, gallbladder disease, acute kidney injury and other problems [1].
Wegovy is approved in an injection form given once weekly and, more recently, in tablet form; the 2.4 mg dose was the one studied in SELECT [1]. The label advises against using Wegovy with another semaglutide-containing product or any other GLP-1 receptor agonist [1].
What happens next
No next steps for the analysis have been disclosed, including whether it will be submitted for publication or presented at a medical meeting [1]. It also has not been reported whether Novo Nordisk plans to ask the FDA to change the Wegovy label based on the finding [1].
Sources
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