Worried About Bone Loss on Semaglutide? It May Actually Protect Against Fractures
New research could pave the way to changing who's eligible for drugs like Wegovy and Ozempic
Key Takeaways
- Experts once worried rapid weight loss from semaglutide could weaken bones.
- New research found semaglutide users had a 15% lower fracture risk.
- Experts say bone density may not automatically rule out semaglutide use.
You’ve done your research on semaglutide medications like Ozempic and Wegovy, and feel confident giving one a try. You want to lower your A1C, lose weight and support your heart health with a simple weekly injection. The problem: You’ve heard that semaglutide may increase the risk of bone loss, which is a serious problem for older adults at higher risk of osteoporosis. Thankfully, new research suggests it may not be time to give up on semaglutide just yet—the effect of semaglutide on bone health may not be what doctors once thought.
What is semaglutide?
“Semaglutide is the generic name for the medications Ozempic and Wegovy,” explains Jeffrey Lee, MD, double-board certified plastic surgeon and founder of JL Plastic Surgery in Boston. “Similar to how ibuprofen is the generic name for Motrin, semaglutide is the active medication while Ozempic and Wegovy are brand names. Semaglutide belongs to a broader class of medications known as GLP-1 receptor agonists, which are used to treat obesity and type 2 diabetes.”
Semaglutides act like the glucagon-like peptide-1 (GLP-1) hormone our bodies make, which is released from our gut after we eat, explains Jessica Duncan, MD, DABOM, DABA, chief medical officer at Ivim Health.
Woman's World Answers
“That hormone does a few things,” Dr. Duncan continues. “It tells your pancreas to release insulin when your blood sugar rises, it slows how fast your stomach empties so you feel full longer and it signals your brain that you’ve had enough [to eat].”
Who should (and shouldn’t) take semaglutide?
Sara Siavoshi, DO, a triple-board-certified physician in neurology, headache medicine and obesity medicine, says these medications are approved for:
Adults with obesity (meaning a BMI of 30 or higher) and adults who are overweight (a BMI of 27 or higher) and have a weight-related condition such as:
- Sleep apnea
- Prediabetes
- Type 2 diabetes
- Cardiovascular disease
- High blood pressure
- High cholesterol
Dr. Duncan shares that semaglutide may not be a good fit for:
- People with a personal or family history of medullary thyroid cancer or MEN2
- Those who are pregnant or breastfeeding
- People with pancreatitis or gastroparesis
Why doctors worry about semaglutide and bone loss
“Osteoporosis is a condition where your bones lose density and become more fragile, which makes them more likely to break,” explains Dr. Duncan. “Bone isn’t a static thing. It’s living tissue that’s constantly being broken down and rebuilt. When that balance tips, and you lose bone faster than you build it, your bones get more porous and weaker over time.”
And that can be a problem if you have or are at risk for osteoporosis and are also taking a GLP-1 medication like semaglutide.
“When you lose a significant amount of weight, you don’t just lose fat,” says Dr. Duncan. “You can also lose bone density along with it. We’ve seen this with other forms of major weight loss, so the worry carried over to GLP-1s. The thinking was that rapid, substantial weight loss might thin the bones and raise the risk of fractures, particularly in people who are already vulnerable, like postmenopausal women.”
Surprising new research on semaglutide and fracture risk
New research presented at an Endocrine Society meeting in Chicago found that people with type 2 diabetes who took semaglutide not only experienced more weight loss than those taking other diabetes and weight-loss medications, including Trulicity, Contrave and Qsymia, but they also had a 15 percent lower risk of bone fractures.
So how did semaglutide manage to shift the perspective around bone loss in this new research? “A few things could be at play here, and I want to be clear that this is me reasoning through the biology, not stating settled fact,” says Dr. Duncan. “First, weight loss itself improves a lot of the things that lead to fractures in the first place. People who lose weight often move better, have better balance and are less likely to fall. Fewer falls means fewer broken bones. Second, better metabolic health matters for bone quality, not just bone quantity.”
What this new research means for you
“This is an interesting and potentially important piece of research, but it should not be interpreted as evidence that semaglutide should now be prescribed specifically to prevent fractures or treat osteoporosis,” cautions Dr. Lee. “Scientific progress often begins with findings like these, which then inspire additional studies that help us better understand the relationship between medications and health outcomes.”
Dr. Duncan adds that this research suggests that having low bone density shouldn’t automatically rule someone out from being eligible to try semaglutide. “But ‘this isn’t an automatic no’ is very different from ‘this is a yes for everyone with osteoporosis.’ These decisions are individual.”
The bottom line on semaglutide and bone loss
As with any medication, semaglutide isn’t a great fit for everyone. But as new research emerges, our understanding of who may benefit from these medications continues to evolve. This new research suggests there may be more room than previously thought to consider semaglutide for people with low bone density or concerns about increased fracture risk. If you’ve been told “no” in the past because of osteoporosis concerns, this could be worth discussing with your doctor again.
Ready for more inspiration? Subscribe to our YouTube channel for video podcasts, health tips and uplifting stories designed for women 40, 50, 60 and beyond.
Conversation
All comments are subject to our Community Guidelines. Woman's World does not endorse the opinions and views shared by our readers in our comment sections. Our comments section is a place where readers can engage in healthy, productive, lively, and respectful discussions. Offensive language, hate speech, personal attacks, and/or defamatory statements are not permitted. Advertising or spam is also prohibited.
