Are weight loss drugs good for your heart? Are they safe?
By: Dr. James Aw, Chief Medical Officer, OMERS
March 9, 2026
A common question in my medical practice is about weight loss drugs. Are they safe? Are they right for me?
Weight loss drugs, known as GLP-1/GIP receptor agonists (i.e. semaglutides, which you may know as Ozempic or Wegovy, and tirzepatides, which you may recognize as Zepbound or Mounjaro), have flooded popular media with commercials and off-label recommendations by social media influencers and entrepreneurs (sometimes referred to as the “pink” market).
These drugs are expensive and there have been supply issues, but patents are expiring and generic formulations are coming to Canada. With weight loss drugs are all over the news and social media, it’s hard to cut through the noise! This is why we should all be aware of scams from fake, AI-generated endorsements and non-pharmacy telehealth distributors and medical spas. In the U.S., some compounding pharmacies are even selling products that are not FDA approved, resulting in government and legal action.
What does the medical community think?
Well, GLP drugs are now accepted as a revolutionary discovery in obesity and chronic disease management. It’s a transformative and modern-day breakthrough drug akin to insulin for diabetes in the 1920s, statins for cholesterol in the 1980s and immunotherapy for cancers in the 2000s. GLP drugs were initially used for diabetes treatment in 2005 but have since been found to cause weight loss of 15-25% (GLP-1 alone or in combination with GIP). Obesity is no longer considered a lifestyle decision, but it is a chronic, complex, relapsing disease that requires lifelong treatment like hypertension and diabetes. In December 2025, the World Health Organization (WHO) issued guidelines endorsing the use of GLP-1/GIP drugs to treat obesity.
February is heart health month. Are these drugs good for the heart?
Recent research says yes! In November 2023, preliminary results from the landmark SELECT trial “Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes” were presented at the American Heart Association conference and received a standing ovation from a room of leading cardiologists. The key finding was that semaglutide reduced heart risk (cardiovascular death, non-fatal heart attack and stroke) by 20% in obese patients with cardiovascular risk factors, but without diabetes. Since then, there have been several important trials that have shown the benefits of these drugs, with reduction in overall mortality, heart failure and kidney disease. The effects of these drugs on the brain-gut axis and inflammation are leading to ongoing studies on their potential use in substance use disorders, dementia (Alzheimer’s), neurodegenerative disorders (Parkinson’s) and metabolic diseases like fatty liver). It’s thought that GLP/GIP drugs may provide benefits through anti-inflammatory mechanisms across many diseases.
Are they right for me?
From a medical point of view, the highest priority patients are overweight diabetics with established cardiovascular disease. Obese patients with chronic kidney disease and heart failure (with preserved ejection fraction) also have established clinical benefit. For everyone else, the studies have shown that even in non-diabetics there is future protective health benefits (particularly in those with risk factors) in addition to improved quality of life. Studies have shown the importance of maintaining healthy lifestyle habits with weight loss medication for optimal health benefits.
However, the drugs aren’t perfect. These medications need to be taken for life and there is a weight loss plateauing effect at 10-25% weight loss from baseline. Weight is regained if you stop the medication. Up to 30% of patients don’t respond to the medication and can’t lose weight. 50% of patients stop taking the drug after one year for various reasons. Most people stop taking the drug because of side effects, with the most common being gastrointestinal upset (nausea, abdominal discomfort, constipation, diarrhea). More serious reported side effects include pancreatitis and gallbladder issues (stones, delayed gallbladder emptying, bile supersaturation from rapid weight loss). Many patients can get muscle wasting (sarcopenia) with rapid weight loss. There have also been rare cases of eye issues. GLP-1 medications are contra-indicated in pregnancy and patients with a personal or family history of thymus and medullary thyroid cancer or multiple endocrine neoplasia type 2 syndrome, and a previous history of bowel obstructions and end stage kidney disease.
Elderly patients (over age 65) may be particularly vulnerable to unwanted side effects (muscle and bone weakness, gastrointestinal symptoms, dehydration, dizziness) which may worsen frailty and lead to falls. Patients on GLP-1 need to maintain adequate protein intake (20-30 g per meal), healthy snacks, daily hydration and strength training.
What’s new?
The newer combination drugs (GLP-1/GIP agonist aka tirzepatide) have higher amounts of weight loss (20-25%) and other combinations are now under development. Traditionally, the medication was given by injection once a week. Now, there are daily oral pill options like Rybelsus or Wegovy for those who don’t like injections. These oral medications do require higher doses to get the weight loss effects, and they must be taken first thing in the morning on an empty stomach and 30 minutes before eating or drinking. Newer versions of medications may not need timing and food/water restrictions (i.e. orforglipron), and other drugs are being developed to minimize muscle wasting (i.e. bimagrumab). Another problem that needs to be solved is whether these drugs can be stopped and result in maintained weight loss. Microdosing has also been tried, but the health effects need to be studied.
Game changers, but not magic bullets
In summary, this class of medications (GLP-1, GIP) are medical game changers for the lifelong treatment of obesity and associated medical conditions, and better versions are coming! However, – these drugs aren’t without risks. If you think they may be right for you, please discuss with your Physician. Always remember to incorporate healthy daily habits (nutrition, exercise, sleep, stress management) as part of your overall well-being strategy!
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