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The news that the weight loss drug Wegovy reduced the risk of heart attacks and strokes in overweight volunteers opens up the door to vastly expanded use of the drug and medicines like it, known as GLP-1 medicines.

That could have a big, positive impact on public health, and it will very likely swell the coffers of the pharmaceutical companies that make these medicines, including Wegovy’s maker, Novo Nordisk, and Eli Lilly, now the most valuable drug company in history thanks largely to hopes for its GLP-1, Mounjaro. These are medicines that could save lives, make money, and perhaps reshape our culture. But they are also, we are learning, not without risk.

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