Infinity Group Medical Director Dr Krish Rawal, explores GLP1 agonist injections, its uses, and its benefits on cardiometabolic health.
For this week’s article, I wanted to cover something which I think a lot of us are becoming very familiar with in terms of the weight loss world and that is the GLP1 agonist injections. However today I am not going to discuss the weight loss side of things so much as the fact that that these particular injection medications are turning out to be a new era in cardiometabolic medicine.
The emergence of glucagon-like peptide-1 (GLP-1) receptor agonists and related incretin-based therapies has transformed the management of type 2 diabetes and obesity. Their effects extend beyond glucose lowering and weight reduction: these medications influence appetite and satiety, gastric emptying and glucagon secretion, and increasingly appear to have important cardiovascular and renal benefits. The 2026 New England Journal of Medicine review has highlighted evidence that GLP-1-based therapies can reduce cardiovascular risk and slow the progression of kidney disease in selected patients, suggesting that their role may be evolving from weight-loss treatments into broader cardiometabolic therapies.
The cardiovascular evidence is very persuasive. In the landmark SELECT trial, involving more than 17,600 adults with overweight or obesity, established cardiovascular disease and no diabetes, weekly semaglutide 2.4 mg (Ozempic or Wegovy) reduced the incidence of cardiovascular death, non-fatal heart attacks or non-fatal stroke by 20% compared with placebo. The 2025 SOUL trial found that oral semaglutide reduced major adverse cardiovascular events in people with type 2 diabetes and established cardiovascular or chronic kidney disease. These findings are important because they suggest that the benefits of GLP-1 therapy may not simply be a consequence of weight loss, but may reflect wider anti-inflammatory, metabolic and vascular effects.
The field is also rapidly evolving, with newer agents demonstrating increasingly substantial weight loss. In the 2025 SURMOUNT-5 trial, tirzepatide (Mounjaro), which acts on two types of body receptors, produced a mean weight reduction of 20.2% at 72 weeks, compared with 13.7% with semaglutide, in adults with obesity without diabetes.
However, these treatments are not without their own side effects. Gastrointestinal adverse effects such as constipation are common, treatment is often long term, and a key issue is the potential loss of lean muscle mass alongside fat mass when the body is in a significant calorie deficit leaving those who do not exercise ultimately worse off in terms of muscle to fat ratio.
The rapid expansion of GLP-1-based medicine therefore represents an important shift in how clinicians are now thinking of managing obesity, but also now focussing more on better cardiometabolic health. Rather than viewing obesity solely as a lifestyle issue, these therapies reinforce the concept of obesity as a chronic, biologically complex disease requiring long-term management.
The challenge now is to ensure that their increasing use (everybody seems to be using them!) is accompanied by good nutritional support and resistance exercise. As newer incretin therapies continue to emerge such as Retatrutide, GLP-1-based treatment may ultimately prove to be one of the most significant developments in preventive and metabolic medicine of the modern era.