A new study suggests that people who take the GLP-1 receptor agonist liraglutide may lose bone density due to rapid weight loss. However, the research found that exercising helped preserve bone loss. Experts said that the findings may apply to other GLP-1s, such as semaglutide, the active ingredient in Ozempic.
A rapid drop in weight can result in a loss of bone density, but a new study suggests that exercising may counteract that side effect for people taking weight management drugs.
The research, published in the journal JAMA Network Open, focused on the GLP-1 receptor agonist liraglutide, used for weight loss and to treat type 2 diabetes. Researchers discovered that people who took the drug but did not exercise regularly lost bone mineral density. At the same time, those on the medication who did routine physical activity had no bone loss despite losing more weight.
The expectation is that exercise would also stave off bone density loss in people taking other GLP-1s, such as semaglutide, the active ingredient in the popular weight loss drugs Ozempic and Wegovy.
In the study, participants consumed about 800 calories daily for eight weeks and were then randomly split into four groups. For nearly four years, one group took 3 milligrams of liraglutide daily, another took a placebo, the third performed moderate-to-vigorous intensity exercise, and the last group took the drug and also exercised.
The exercise consisted of group sessions involving 30-minute interval-based indoor cycling and 15-minute circuit training workouts, which included both aerobic exercise and resistance training (with weights and without).
The researchers found that those taking liraglutide had more bone loss than those in the exercise group, despite similar weight loss. Participants in the combination exercise-GLP-1 group experienced the most weight loss, but their bone mineral density levels remained similar to those not taking the medication. Furthermore, people on liraglutide lost similar amounts of weight as the combination group but lost more bone mineral density in their hips and spine compared to those who engaged solely in exercise.
The study is unique because it includes people with obesity but not diabetes, which makes it clearer that any bone loss may be due to the medication rather than the disease.
While the study suggests that exercise can boost the bone health of people on GLP-1s, a few factors should be considered. For one, the study focused on people younger than 65 and those without chronic health issues, like diabetes, so the results may not apply to these groups.
It makes sense that exercise would help preserve bone health for people taking GLP-1s. Exercise builds and preserves muscle mass, which affects the biomechanical stress and force on bones during movement.
The big takeaway from this study is diet and exercise are fundamental to healthy living and improving metabolic health. Whether the endpoint is weight loss or metabolic health, all studies continue to demonstrate that weight loss interventions with medications or surgery have better outcomes when diet and exercise are incorporated.
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