J Am Coll Cardiol

ACC: Weight-loss drugs move to front of the line for cardiovascular risk reduction

June 27, 2025

The American College of Cardiology’s (ACC’s) 2025 Concise Clinical Guidance outlines the clinical decision-making process for clinicians to incorporate pharmacologic weight management strategies into cardiovascular care.

Key Highlights

• Obesity is a chronic, progressive disease with major cardiovascular consequences—including heart failure, coronary artery disease, and stroke—and should be treated as such.
• GLP-1 and GIP/GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) are now recommended as first-line pharmacologic options for eligible patients. These agents have shown superior efficacy in weight loss and cardiovascular risk reduction compared to lifestyle changes alone.
• Lifestyle interventions remain important, but patients should not be required to “try and fail” before initiating medication. Instead, pharmacotherapy should be considered early and used in combination with behavioral support.
• Eligibility is based on BMI and other risk indicators, with treatment tailored to minimize side effects and maximize benefit.
• Multidisciplinary, team-based care is emphasized to address comorbidities, personalize treatment, and reduce weight stigma in clinical settings.
• Access and affordability remain key barriers; clinicians are encouraged to advocate for equitable coverage of anti-obesity medications.

Source:

Kittleson MM, et al. (2025, June 10). J Am Coll Cardiol. 2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure: A Report of the American College of Cardiology. https://pubmed.ncbi.nlm.nih.gov/40512113/