While weight-loss drugs have made headlines for their impressive results, they’ve also made waves due to the potential side effects they can cause. Gastrointestinal (GI) issues have been among the most common, but they are far from the only issues that have arisen among patients. The treatments can also result in loss of muscle mass and bone density, doctors previously warned. However, it’s worth noting that decreased muscle and bone mineral density (BMD) is a big concern with weight loss in general, which is why a new study aimed to evaluate how bone health would be affected by different interventions, including liraglutide (better known by the brand names Saxenda and Victoza).
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Data from a randomized clinical trial was published in JAMA Network Open in June, evaluating the effect of liraglutide—a glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment—on bone health. The study included 195 participants between the ages of 18 and 65, all of whom had obesity but did not have diabetes.
Following an eight-week low-calorie diet, study participants were assigned to either exercise alone, a 3.0-mg daily dose of liraglutide, a combination of both exercise and liraglutide, or placebo for a year.
While participants in all four groups lost weight, when looking at the effect on BMD, researchers found that the combination of exercise and liraglutide was “the most effective weight loss strategy while preserving bone health.”
Interestingly, even though people who only exercised and people who only took liraglutide lost a similar amount of weight, those on the medication had a greater reduction in BMD at clinically relevant sites (the hip, spine, and forearm).
The study had its limitations, notably because it was limited to adults without other chronic diseases like diabetes. Research was also conducted in Denmark, where there is “an ancestrally homogenous study population.”
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As Kunal Shah, MD, assistant professor in the division of endocrinology at the Rutgers Robert Wood Johnson Medical Center, told Women’s Health, the loss of muscle mass and bone density “are the biggest concerns” for those taking weight-loss drugs, but both can also occur when you’re losing weight in general. The study authors point out that “weight loss-induced bone loss” has been observed after gastric bypass and after long-term calorie restriction in younger adults with and without obesity.
“Thus, weight loss-induced bone loss likely carries a risk across the lifespan, and identifying treatments that induce clinically relevant weight loss while minimizing bone loss is essential in long-term obesity management,” the study introduction reads.
Doctors told Women’s Health that resistance training, as well as walking or running, can help keep bones strong while on a weight-loss drug. Shah also noted the importance of talking to your doctor and following up to ensure that your bone density isn’t being negatively affected by the medication you’re prescribed.