Emerging Role of Weight-Loss Medications in the Management of Heart Failure: Current Evidence and Future Perspectives

Heart failure is a major global health concern as it contributes to high rates of mortality and morbidity, with high rates of hospitalizations. The most prevalent risk factor or comorbidity of heart failure is obesity, which not only worsens and exacerbates disease progression and the course of illness, it also reduces its prognosis. Weight management is still not well addressed, even with major advancements in heart failure pharmacotherapies. Recent advances in weight-loss medications such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and other novel anti-obesity drugs have sparked interest in their potential to improve clinical outcomes for patients with heart failure, especially those who also have obesity-related cardiac dysfunction. Weight-loss medications benefit heart failure by reducing adiposity-related inflammation, myocardial stress, and remodeling. These effects are auspicious in heart failure with preserved ejection fraction, where obesity-driven mechanisms play a critical role. These medications have been demonstrated to help with weight reduction, improve heart failure symptoms, and reduce hospitalization rates. However, questions about their long-term safety, particularly in patients with severe heart failure, are still being researched. The purpose of this review is to summarize the current evidence on the safety and effectiveness of weight-loss medications in the treatment of heart failure, describe their mechanisms of action, and highlight knowledge gaps that require further research.