ACC Endorses Early Use of Anti-Obesity Medications: New Guidance Supports Semaglutide and Tirzepatide
ACC Endorses Early Use of Anti-Obesity Medications: New Guidance Supports Semaglutide and Tirzepatide
Date Published: June 20, 2025
JACC. Jun 20, 2025. Epublished DOI:
Key Scientific Highlights
1. New Guidance by the ACC:
The American College of Cardiology now recommends considering pharmacotherapy as a first-line treatment for eligible patients with obesity, rather than waiting for lifestyle changes to “fail.”
2. Combination Approach:
While medications may be initiated early, lifestyle interventions (diet, physical activity) must still be offered alongside drug therapy.
3. Medications in Focus:
• Semaglutide (GLP-1 agonist; Wegovy, Ozempic – Novo Nordisk)
• Tirzepatide (Dual GIP/GLP-1 agonist; Zepbound, Mounjaro – Eli Lilly)
Both have shown significant weight loss effects and cardiovascular risk reduction.
4. Clinical Benefits:
• Semaglutide: Proven cardiovascular benefit in patients with and without diabetes.
• Tirzepatide: Also improves outcomes in sleep apnea and HFpEF; may result in slightly greater weight loss than semaglutide in some trials.
5. Guidance Emphasis:
• Choice between drugs depends more on insurance coverage and availability than clinical superiority.
• Weight management should be addressed by multidisciplinary teams, not individual cardiologists.
6. Expert Opinion:
“Patients should not be required to ‘try and fail’ lifestyle changes prior to initiating pharmacotherapy,”
– Dr. Olivia Gilbert, Chair of the ACC Guidance
7. Clinical Considerations:
• The burden of obesity on cardiovascular disease (CVD) justifies active involvement from cardiologists.
