Glucagon-like-peptide-1 (GLP-1) agonists are beneficial for glycaemic control, weight loss, and cardiovascular health. Because GLP-1 agonists may be a useful tool in the management of obesity in patients with congenital heart disease (CHD), we examined whether GLP-1 agonists are effective and safe for weight loss in adults with congenital heart disease (ACHD) and explored the effects of sex and CHD complexity.

We conducted a retrospective cohort study of ACHD patients who were prescribed a GLP-1 agonist from 1/1/2022–3/31/2024 at Yale New Haven Hospital. Patients were subdivided by CHD anatomic complexity. The primary outcome was the change in weight over time. Side effects were explored as a secondary outcome.

The moderate complexity ACHD group had the fastest weight loss during both the first 6 months and 12 months of treatment, but was comparable to the other two ACHD complexities in the full period of follow-up. Patients in the simple and great complexity groups required 12 months of treatment to reach meaningful weight loss. Females had a faster rate of weight loss compared to males across all ACHD complexity levels. The most common side effects reported were gastrointestinal, such as nausea, acid reflux, and diarrhoea.

This study provides evidence that GLP-1 agonists are effective for weight loss in ACHD patients, with the greatest weight loss in females and patients with moderate ACHD complexity. Moreover, GLP-1 agonists in the ACHD population have a reasonable side effect profile that is typical for these agents.