Do GLP-1 drugs like Ozempic or Wegovy affect bone density?
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as Ozempic (semaglutide) and Wegovy (semaglutide), are widely used for treating type 2 diabetes and weight loss. Recent studies highlight potential risks to bone mineral density (BMD) and fracture risk, particularly in specific patient populations. Incorporating a regular exercise routine can help mitigate potential bone loss from GLP-1 drugs due to rapid weight loss.
How Do GLP-1 Drugs Affect Bone Density?
GLP-1 drugs influence bone metabolism through receptors in bone-forming osteoblasts and bone-resorbing osteoclasts:
- Increase bone formation by stimulating osteoblast activity.
- Reduce bone breakdown by inhibiting osteoclast development.
These drugs also affect bone health indirectly:
- Better blood sugar control reduces fracture risk in diabetes patients.
- Rapid weight loss may cause hormonal changes that accelerate bone loss.
- Reduced appetite in adolescents may impact bone development due to lower nutrient intake.
Research is ongoing to study the effects of GLP-1 drugs on bone development in adolescents. There is concern about whether patients in this age group taking GLP-1 drugs might not get enough nutrition due to a decreased appetite, which could impact bone health.
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What Does Research Say About GLP-1 Drugs and Bone Health?
- 2018 Meta-Analysis (49,000 Participants): Found GLP-1 drugs were associated with a lower fracture risk compared to placebo or other diabetes medications, with exenatide showing the lowest risk.
- 2024 JAMA Study (195 Adults with Obesity, 52 Weeks): Exercise + GLP-1 therapy helped maintain bone density at the hip, spine, and forearm vs. GLP-1 therapy alone (liraglutide) led to reduced bone mineral density at the hip and spine.
- 2022 Systematic Review: Reported no significant effect of GLP-1 drugs on bone density or fracture risk in type 2 diabetes patients (limited by small sample sizes).
Summary
GLP-1 drugs appear to have a neutral to minimal impact on bone health. However, rapid weight loss can contribute to bone loss. Incorporating regular exercise may help preserve bone density during treatment. If you have concerns about bone health while taking GLP-1 medications, consult your healthcare provider.
References
Daniilopoulou, I., et. al. 2022. The Impact of GLP1 Agonists on Bone Metabolism: A Systematic Review. In: Medicina. DOI: https://doi.org/10.3390/medicina58020224
Jensen, S. B. K., et al. 2024. Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial. In: JAMA. DOI: https://doi.org/10.1001/jamanetworkopen.2024.16775
UCI Health. 2024. GLP-1 weight loss drugs can affect bone development in adolescents. Accessed 02/24/2025 at https://www.ucihealth.org/news/2024/12/ozempic-bone-health
Xie, B., et. al. 2021. The Impact of Glucagon-Like Peptide 1 Receptor Agonists on Bone Metabolism and Its Possible Mechanisms in Osteoporosis Treatment. In: Frontiers. DOI: https://doi.org/10.3389/fphar.2021.697442
Zhang, Y. S., et. al. 2018. Glucagon-like peptide-1 receptor agonists and fracture risk: a network meta-analysis of randomized clinical trials. In: Osteoporosis International. DOI: https://doi.org/10.1007/s00198-018-4649-8
Read next
How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?
Ozempic, Mounjaro, Wegovy and Zepbound can all lead to long-term weight loss, but only Wegovy and Zepbound are approved by the FDA for this use. In studies, Zepbound has led to a 21% weight loss in adults using the highest dose, while Wegovy has led to about a 15% weight loss.
Continue reading
How long does it take for Ozempic to work?
Your blood glucose (sugar) levels should start to fully decline within the first week after you start using Ozempic (semaglutide) at your regular dose. However, the full effect can take 8 weeks or longer, as this is a long-acting medication that is injected only once per week. Continue reading
Wegovy vs Ozempic: Which is Right for You?
Both Wegovy and Ozempic contain semaglutide, but Wegovy is prescribed for long-term weight management while Ozempic is used to control blood sugar levels in type 2 diabetes and help protect kidney function. They both lower the risk for heart-related complications, but they differ in other approved uses, doses, target populations and costs. Continue reading
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