Hormonal
Treatment with GLP-1 receptor agonists (e.g., semaglutide 2.4 mg, liraglutide 3.0 mg) or GLP-1/GIP co-agonists (tirzepatide) is recommended for adults with overweight or obesity at moderate or high ASCVD risk to reduce weight and cardiovascular risk factors.
If you have overweight or obesity and are at moderate or high cardiovascular risk, ask your doctor about GLP-1 medications like semaglutide or tirzepatide. These are recommended treatments that significantly reduce weight and cardiovascular risk factors, often more effectively than lifestyle changes alone.
Treatment with a glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1 RA) or GLP-1/Glucose-dependent insulinotropic polypeptide (GIP) receptor co-agonist is RECOMMENDED for adults with overweight or obesity at MODERATE or HIGH ASCVD RISK to reduce weight and CV risk factors.
Why this rating
Based on multiple large RCTs (STEP 1, SURMOUNT-1, SCALE) with low heterogeneity.
Source
2025 Brazilian evidence-based guideline on the management of obesity and prevention of cardiovascular disease and obesity-associated complications: a position statement by five medical societies
Cynthia Melissa Valério et al. · Diabetology & Metabolic Syndrome · 2025
DOI 10.1186/s13098-025-01954-8
More from this paper
- Sustained weight loss of at least 5% is recommended for individuals with overweight or obesity at moderate atherosclerotic cardiovascular disease (ASCVD) risk to reduce cardiometabolic risk factors and delay type 2 diabetes onset.Strong
- Sustained weight loss of at least 10% from maximum weight is recommended for adults with overweight or obesity at moderate or high ASCVD risk to reduce cardiovascular events.Good
- Semaglutide 2.4 mg is recommended for secondary prevention of cardiovascular events in individuals with BMI ≥27 kg/m² without diabetes but with established cardiovascular disease.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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