The American College of Cardiology has issued a Concise Clinical Guidance (CCG) document to aid clinicians in the use of medication for weight management in patients where treatment may provide cardiovascular benefit.
Obesity is a chronic, progressive disease that affects over 1 billion people worldwide. It can lead to devastating cardiovascular complications, including increased risk of heart failure, coronary artery disease and stroke. It is also associated with a significant reduction in life expectancy (9.1 years in men and 7.7 years in women.) Treatment is essential, but not all weight loss methods are effective.
Modern obesity medications, including semaglutide and tirzepatide, have been proven more effective than lifestyle interventions at not only weight loss, but at reducing overall cardiovascular disease (CVD) risk, with fewer risks than procedure-based interventions. Prior guidelines have recommended trying lifestyle interventions before beginning medication, but this new guidance recommends considering these medications as a first-line treatment option for eligible patients.
“Patients should not be required to ‘try and fail’ lifestyle changes prior to initiating pharmacotherapy; nonetheless, lifestyle interventions should always be offered in conjunction with obesity medications,” said Olivia Gilbert, MD, MSc, FACC, Chair of the CCG and a cardiologist at Atrium Health Wake Forest Baptist Medical Center.
The new guidance outlines the clinical decision-making process for clinicians to incorporate pharmacologic weight management strategies into cardiovascular care, highlighting the following key areas:
“Weight management by the cardiovascular community needs to be embraced, given both the prevalence of obesity and the impact it has on many forms of CVD,” Gilbert said.
“2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on Medical Weight Management for Optimization of Cardiovascular Health,” will be published in JACC , the flagship journal of the American College of Cardiology. For an embargoed copy, contact Nicole Napoli at nnapoli@acc.org .
Last week, ACC also issued a Scientific Statement that addresses the management of obesity specifically in adults with heart failure (HF), with a specific focus on those with stage 2 HF with preserved ejection fraction (HFpEF). It is the first in a new series of clinical guidance from the College aimed at informing clinicians about areas where evidence is new and evolving or where sufficient data are more limited.
"Given emerging evidence of the benefits of semaglutide and tirzepatide in individuals with HFpEF and obesity in concert with healthy behavioral interventions, clinicians should be aware of optimal diagnosis, risk assessment, and management of obesity in individuals with HF," the authors said.
“ 2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure: A Report of the American College of Cardiology ,” published in JACC on June 13, 2025.
The American College of Cardiology (ACC) is a global leader dedicated to transforming cardiovascular care and improving heart health for all. For more than 75 years, the ACC has empowered a community of over 60,000 cardiovascular professionals across more than 140 countries with cutting-edge education and advocacy, rigorous professional credentials, and trusted clinical guidance. From its world-class JACC Journals and NCDR registries to its Accreditation Services, global network of Chapters and Sections, and CardioSmart patient initiatives, the College is committed to creating a world where science, knowledge and innovation optimize patient care and outcomes. Learn more at www.ACC.org or connect on social media at @ACCinTouch.
The ACC’s JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology ( JACC) — and specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging , JACC: Cardiovascular Interventions , JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at JACC .org .
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Journal of the American College of Cardiology