Can weight loss help with cardiomyopathy?
Many people with cardiomyopathy, especially those with heart failure and preserved ejection fraction, are advised by their doctors to lose weight. Studies have shown that losing weight can help reduce symptoms and improve overall heart health.
Weight loss injections, like Mounjaro (Tirzepatide) and Wegovy (Semaglutide), are a newer option that some people use to help with weight loss. However, these medications are not suitable for everyone, and it’s important to speak to a doctor before considering them.
What are weight loss injections, and how do they work?
These injections help people lose weight by making them feel fuller for longer and reducing cravings.
Mounjaro (Tirzepatide)
How it works:
- It works on two hormones (GLP-1 and GIP) to reduce appetite and improve sugar control.
How it's taken:
- It's self-injected once a week. The dose increases every 4 weeks until a maintenance dose is reached.
Wegovy (Semaglutide)
How it works:
- It works on one hormone (GLP-1) to make you feel fuller.
How it's taken:
- It's self-injected once a week. Dose increases every 4 weeks until a maintenance dose is reached.
Both medications have been shown to help people lose 15-20% of their body weight over 12-18 months when combined with healthy eating and exercise.
Are weight loss injections safe for people with heart conditions?
The European Society of Cardiology (ESC) has stated that GLP-1 medications can have benefits for people with heart disease and obesity. However, more research is needed to understand their long-term effects fully.
The National Institute for Health and Care Excellence (NICE) recommends Semaglutide (Wegovy) for weight loss in people with a high BMI, but only if they also have Type 2 diabetes and have not responded to other treatments. Tirzepatide (Mounjaro) is currently only recommended for patients with Type 2 diabetes and a high BMI.
These medications are not suitable for everyone and should be used with caution if you:
- Are pregnant or trying to conceive.
- Have liver or kidney disease.
- Have a history of pancreatitis or diabetic retinopathy.
- Take certain other medications, including oral contraceptives (as absorption may be affected).
It’s essential to speak to a GP or cardiologist before considering weight loss injections.
What does the research say?
Several trials have looked at how these medications affect people with obesity and heart conditions:
SELECT trial (2023, 17,604 people):
- Found that Semaglutide reduced the risk of heart attacks, strokes, and cardiovascular death.
- People lost an average of 9.4% of their body weight.
- Improvements were seen in blood pressure, blood sugar, cholesterol, and inflammation.
STEP HFpEF trial (2023, 516 people):
- In patients with heart failure and preserved ejection fraction, Semaglutide helped reduce symptoms, improve exercise ability, and led to greater weight loss compared to a placebo.
SUMMIT trial (2024, 731 people):
- Tirzepatide was linked to a lower risk of heart-related deaths or worsening heart failure in people with obesity and heart failure with preserved ejection fraction.
There have been no trials yet looking at these medications in people with heart failure and reduced ejection fraction.
Can I get weight loss injections on the NHS?
At the moment:
- Mounjaro (Tirzepatide) is not available on the NHS for weight loss.
- Wegovy (Semaglutide) is available only for people with obesity and Type 2 diabetes.
Some people choose to access these medications privately through weight management clinics or online pharmacies. However, it’s important to get medical advice first to check whether they are safe and suitable for you.
What should I do next?
If you're considering weight loss injections, speak to your GP or cardiologist. They can help you understand whether they’re right for you and discuss other options for weight management.