A study to determine the effects and safety of starting a glucagon-like peptide-1 receptor agonist before planned cardiac surgery.

This study looks at semaglutide a glucagon-like peptide-1 receptor agonist in people with class II and above obesity undergoing elective cardiac surgery. The medication will be titrated according to manufacturer recommended dose escalation regime over a 16-week period as follows to achieve a maintenance dose of 2.4mg once weekly subcutaneously. Agonist will be administered after first DEXA scan until presentation for surgery i.e. no minimum or maximum time on medication to be included in study results. • Week 1-4: 0.25mg subcutaneous (sc) weekly dose • Week 5-8: 0.5mg sc weekly dose • Week 9-12: 1mg sc weekly dose • Week 13-16: 1.7mg sc weekly dose • Maintenance dose: 2.4mg sc weekly dose Not all participants may reach the full medication dose as they may have their surgery prior to the 16 weeks or they may stop due to adverse events, and this will not affect their ability to participate in the study. Participation in the study will not delay scheduled surgery. We will be calling participants every 4 weeks to check adherence and any side effects that may have stopped them from continuing the medication.