New guidelines to shape use of GLP-1 agonists in obesity and cardiovascular disease

The Heart Foundation is mobilising clinical experts and peak bodies to address a critical health issue in Australia: the intersection of obesity and cardiovascular disease.

With two-thirds of Australian adults now diagnosed as overweight or obese, the Heart Foundation is bringing together national clinical experts and peak health bodies to develop a consensus statement on the management of obesity in the context of cardiovascular disease in the coming months.

With new pharmacological treatments for weight loss showing cardiovascular benefits – such as Novo Nordisk’s GLP-1 receptor agonist, Wegovy (semaglutide), and Lilly’s dual GIP and GLP-1 receptor agonist, Mounjaro (tirzepatide) – clinical guidance is needed now more than ever for healthcare professionals, policymakers, and the public. 

“Obesity is a leading driver of cardiovascular disease, yet its role in cardiovascular health is often overlooked,” said Professor Garry Jennings, Chief Medical Adviser at the Heart Foundation.

“We are lucky to have a number of new treatment options available, and many more on the horizon, to not only support weight loss but also improve cardiovascular outcomes in people that need it most. This consensus statement will provide much-needed guidance for clinicians and reinforce the importance of tackling obesity as part of heart disease prevention.”

Lilly is expected to submit Mounjaro for inclusion on the Pharmaceutical Benefits Scheme (PBS) by mid-2026, while Novo Nordisk has already had two submissions for Wegovy rejected by the Pharmaceutical Benefits Advisory Committee (PBAC). A new application has now been resubmitted for evaluation.

The Royal Australian College of General Practitioners (RACGP) has updated its position on weight-loss medicines, supporting the inclusion of effective obesity treatments on the PBS. The shift reflects growing recognition that pharmacotherapy, when guided by evidence, has a legitimate place in tackling Australia’s obesity epidemic.

Wegovy, currently approved by the TGA in injectable form, continues to build its evidence base. The recently published SOUL trial, revealed that once-daily oral Wegovy reduced the risk of major adverse cardiovascular events in adults with type 2 diabetes and a history of atherosclerotic cardiovascular disease, chronic kidney disease, or both.

This marks the first large-scale trial to demonstrate that the oral from of Wegovy offers not just cardiovascular safety but measurable cardiovascular benefit. In the study, major adverse cardiovascular events occurred in 12.0% of patients on Wegovy compared to 13.8% in the placebo group. This equates to a 14% relative risk reduction and an absolute risk reduction of 2% over three years, with a number needed to treat (NNT) of 50 to prevent one event.

Although stroke and cardiovascular death were slightly lower, these differences were not statistically significant. Kidney outcomes also showed a favourable trend, but again without reaching statistical significance.

The Heart Foundation’s initiative is designed to provide a clear, evidence-informed roadmap for health professionals. The work will unfold in three key phases: the formation of a national expert taskforce, a joint stakeholder meeting to examine clinical and policy priorities, and the publication of a consensus statement offering evidence-based, practical guidance for health professionals. 

Beyond clinical impact, the economic stakes are high. The Global Obesity Observatory estimates the current cost of overweight and obesity to the Australian economy at $40 billion – equivalent to 1.9% of GDP. If left unaddressed, this is forecast to skyrocket to $252 billion, or 3.5% of GDP, by 2060.

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