Perspective commentary examining the American College of Cardiology's endorsement of semaglutide (Wegovy) as first-line weight management therapy—a paradigm shift in cardiometabolic care—while addressing concerns about long-term safety, access equity, and healthcare system prioritization. Reviews both the evidence base for this guideline change and the legitimate concerns about its implementation. Provides a balanced critical perspective on semaglutide's elevation to first-line cardiovascular therapy status—articulating both the scientific justification and the healthcare system tensions created by prescribing a high-cost drug at population scale.
Shoaib, Navaira; Azhar, Naveen; Shoaib, Maria