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GLP-1 Medications and Low Bone Density: What You Need to Know to Protect Your Bones

GLP-1 Medications and Low Bone Density: What You Need to Know to Protect Your Bones

   Blog    April 17, 2025  |  0
Medications and inject-able pens sit on a counter to illustrate the relationship between GLP-1-medications-and-low-bone-density

By Laura Yecies

If you’re taking a GLP-1 medication like Ozempic or Wegovy, chances are you’re on a journey to improve your health and longevity. These medications have been life-changing for people struggling with obesity and type 2 diabetes, offering effective weight loss and better metabolic control. But there’s one important area of research emerging, and it’s concerning: the relationship between GLP-1 medications and low bone density.

Since GLP-1s were first approved for weight loss and the market took off, there has been significant concern about the relatively high rate of loss of lean body mass, particularly muscle, especially as compared with traditional weight loss techniques. Adequate protein consumption and weight lifting can help mitigate this. https://pubmed.ncbi.nlm.nih.gov/38937282/

The other part of lean body mass that is lost, usually without us being aware, is bone. Strong bones are the foundation of a healthy, active life, yet the connection between GLP-1 medications and bone density hasn’t gotten the same attention as the effect on muscles. Yet, existing and ongoing research is continuing to show a deleterious relationship. 

Let’s break it down and discuss what you can do to protect your bones while improving your overall health.

What We Know About GLP-1s and Bone Density

New research presents a complex picture regarding the impact of GLP-1 medications on bone health. While a few studies suggest potential benefits, many indicate concerns about bone mineral density (BMD) and fracture risk.

The biggest question: Is there a causal relationship from the drugs themselves, or is bone loss a side effect of successful (and often rapid) weight loss? 

We know that weight is a factor in bone density. Being under 127 lbs is considered a risk factor for osteoporosis. We at Osteoboost understand this phenomenon quite well. The same concept of mechanical loading that makes vibration therapy so effective drives improved bone density in many people who carry more weight. The higher stress on your bones from higher body weight spurs bone formation.

However, given the growing prevalence of bone density issues among patients taking GLP-1 medications, the possibility that the drugs themselves may directly affect bone density is being taken quite seriously.

The body of research on both the positive and negative effects of GLP-1s on bone density is growing quickly. Here are a few we’ve found useful:

Positive Effects

  • A study published in JAMA Network Open found that a combination of exercise and GLP-1 RA preserved hip, spine, and forearm BMD despite larger weight loss. (jamanetwork.com)
    • Furthermore, the study revealed that combining the GLP-1 RA liraglutide with exercise resulted in significant weight loss while preserving bone health in adults with obesity. Participants who combined the medication with exercise did not experience bone density loss, unlike those who took the medication without exercising. 

Negative Effects

  • A study from the University of Colorado Anschutz Medical Campus found that GLP-1 RAs are associated with an increased fracture risk in obese patients without diabetes, particularly in those with a body mass index (BMI) over 40 and aged over 68. (medschool.cuanschutz.edu)
    • The study also stated that GLP-1 associated weight loss may increase the risk of fracture due to associated muscle loss and trabecular bone loss from the decreased mechanical load on bone. 
  • A study just published in JBMR concluded that “a high-protein diet benefits muscle mass, even under CR (calorie restriction). However, a low-calorie and high-protein diet accentuates the detrimental impact that CR has on bone”

These findings underscore the importance of a comprehensive approach to weight loss that includes regular exercise to mitigate potential adverse effects on bone health associated with GLP-1 use.

The FDA Has Noticed, Too

The FDA has highlighted the potential risk of fractures with some GLP-1 medications. The label for Wegovy includes a warning of the risk of hip fracture: “More fractures of the hip and pelvis were reported on WEGOVY® than on placebo in female patients: 1% (24/2448) vs. 0.2% (5/2424).” 

How to Protect Your Bones While on GLP-1 Medications

Exercise does appear to be a key ingredient to a bone-sparing weight loss or diabetes treatment with GLP-s. 

  1. Make Exercise a Priority – Weight-bearing and resistance exercises (like walking, jogging, and strength training) help keep bones strong. If you’re losing weight, adding exercise can help protect against bone loss. 
  2. Check Your Bone Density – get a baseline DXA, and if you’re on a GLP-1 medication for an extended period, ask your doctor about getting a bone density scan to monitor any changes.
  3. Fuel Your Bones – Ensure you get enough protein, calcium, and vitamin D. A healthy diet with bone-supporting nutrients can make a big difference.
  4. Try Targeted Therapies – Technologies like Osteoboost’s precision vibration therapy provide mechanical stimulation to the bones, helping maintain strength in key areas like the hips and spine.
  5. Talk to Your Doctor – Have an open conversation with your healthcare provider about your risks and what you can do to minimize them. Your health is a partnership, and you deserve to feel informed and empowered.

Your health journey is about more than just weight loss or controlling your diabetes. It’s about creating a strong, resilient body that supports you for years to come. At Osteoboost, our mission is to help people live more active and fulfilling lives longer into their golden years. This isn’t just a company goal but a personal one for me as well. GLP-1 medications can be an incredible tool for weight loss, but we don’t want that success to come at the cost of other important longevity goals. If you’re using a GLP-1 medication and want to be proactive about your bones, we’re here to help. Taking steps to protect your bones now will help you stay active, independent, and thriving well into the future.

References

Reviewed 5/2025 by Osteoboost Chief Medical Officer Pamela Peeke, MD, MPH, FACP, FACSM

 

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