Study proposes expanding GLP-1 use for heart protection in overweight adults
A Danish study presented at EASD suggests GLP-1 receptor agonists could benefit millions more people with overweight who are not currently eligible for weight-loss treatment. The research focused on individuals with a BMI of 25–26.9 and elevated remnant cholesterol or low-grade inflammation, comparing their heart disease risk with that of currently eligible patients. The authors argue extending indications could reduce coronary heart disease risk in this group.
The Danish team examined UK Biobank and Copenhagen General Population Study records for 313,145 adults with BMI at least 25, median age 58 and roughly half women, all initially free of diabetes and coronary heart disease. Over follow-up exceeding ten years, 23,134 participants developed coronary heart disease.
Roughly two-thirds met current GLP-1 RA weight-loss criteria. Among the rest, most had BMI 25–26.9, and nearly half of that subgroup showed elevated remnant cholesterol, low-grade inflammation, or both. Their heart-disease risk matched that of people already eligible for treatment.
If indications broaden, adults with BMI 25–26.9 and certain risk markers might gain access to drugs currently limited to higher BMI or additional conditions. This may shift prevention toward earlier treatment, potentially reducing heart disease burden, but could also raise questions about cost, access, and long-term use. Clinicians and health systems may need clearer risk-based criteria.