🧪 Dual GLP-1/GIP agonists: weight loss and CV risk factors

In a recent review of obesity–cardiovascular disease pathways and therapies, incretin agonists (GLP-1 RAs and dual GLP-1/GIP agonists) were linked to 10–20% weight loss and meaningful cardiometabolic improvement, including lower risk of major adverse cardiovascular events (CV death, nonfatal MI, stroke). Benefits were observed in patients with and without Diabetes mellitus (DM), and tirzepatide showed superior weight-loss efficacy vs GLP-1 monotherapy.

Why It Matters To Your Practice

• Obesity pharmacotherapy is shifting from “weight-only” management to a CV risk-reduction strategy you can implement alongside lifestyle and, when appropriate, metabolic bariatric surgery.

• Evidence that CV protection extends beyond glycemic control supports considering incretin-based therapy even when A1c is not the primary problem (including patients without DM).

Clinical Benefits

• Expected weight reduction with incretin agonists: ~10–20% in clinical trials, with dual GLP-1/GIP therapy generally outperforming GLP-1 monotherapy for weight loss (notably tirzepatide).

• Cardiometabolic improvements include reduced risk of major adverse cardiovascular events (CV death, nonfatal MI, stroke) in studied populations.

Managing Risks

• Set expectations for adherence and duration: benefits are tied to early and sustained therapy, so plan follow-up for titration, tolerability, and long-term maintenance.

• Integrate rather than substitute: pair pharmacotherapy with nutrition, activity, and risk-factor management; consider referral pathways for metabolic bariatric surgery in appropriate candidates.

The Bottom Line

• Dual GLP-1/GIP agonists are linked to substantial weight loss (10–20%) and improvements in CV outcomes and risk factors, including in patients without DM.

• For high-risk patients, these agents support a more proactive, personalized obesity care plan aimed at both weight reduction and cardiovascular risk reduction.