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Is Loss of Bone Density Preventable?

Losing excess weight is incredibly important for your health. It helps you reduce health risks, such as type 2 diabetes and heart disease. However, calorie restriction often causes you to lose more than just fat mass. Loss of bone health can be detrimental to your overall health, quality of life, and longevity. A new JAMA Network journal entry suggests that a combination of exercise and GLP-1 medication helps preserve bone health during the weight loss process.

Study Reveals that Exercise Can Help Preserve Bone Health When Losing Weight

A journal entry published on the JAMA Network, authored by S.B.K, Jensen, et al., analyzed the results of a previous randomized clinical trial. The paper focuses on presenting more evidence on how bone mass can be preserved when you use GLP-1 medications such as Ozempic and Wegovy to lose weight.

The main objective was to compare different approaches to weight loss, including:

●      Exercise alone

●      The use of GLP-1 RA medication

●      Combination therapy with both

Previous studies have examined GLP-1 receptor agonists in treating obesity. For example, a review paper in the International Journal of Molecular Sciences considered results from multiple clinical trials that focused on using GLP-1 agonists as a treatment for obesity in particular.

However, while many existing reviews focus on weight loss, along with improvements in insulin sensitivity and other metrics, there isn’t enough evidence to explain how this treatment would affect bone health.

It’s well-known that bone mass can decline with weight loss. This is why the JAMA Network journal entry is so important, as it sheds more light on this particular topic. Low bone mineral density increases the risk of fractures and injuries, especially among older individuals.

The clinical trial that the researchers analysed had 195 adult participants. All these patients were obese at the time of the study. Bone mineral density was recorded in the forearm, spine, and hip.

This trial lasted for one year, which gave the researchers enough time to examine how these three treatment options affected the patients. The study involved both the Hvidovre Hospital and the University of Copenhagen, both located in Denmark.

The study didn’t start with the interventions right away. Instead, all the participants who were included in the clinical trial were first put on a calorie-restricted diet for eight weeks. These individuals were allowed to eat 800 kcal per day.

After collecting the results from the initial period, the researchers used a randomized system to divide the participants into four groups. Each group had to undergo treatment over a 52-week period.

The four groups included:

  1. Exercise program with no other interventions. The workout routine was developed to be moderate to vigorous in intensity.

  2. Liraglutide 3.0mg per day , without any other intervention.

  3. A combination of 3.0mg liraglutide and the moderate to vigorous training program.

  4. Placebo group.

Regular follow-ups were done to determine the efficacy of each group. In the group that only took liraglutide daily, there was a significant reduction in total body weight. However, the researchers also found that these individuals' bone mineral density in the hip, forearm, and spine declined.

Bone mineral density did not decline in the group that used exercise alone or combination therapy. The weight loss results were also much more significant in the combination group, with a mean weight loss of 16.88kg. In the exercise group, the mean figure was 11.9kg, and the liraglutide group had a mean reduction of 13.74kg.

All the results in terms of weight loss were more impressive than the placebo group, where the mean was only 7.03kg. 

What Can We Learn from This Study

The analysis published on JAMA Network offers valuable insight into how healthcare providers should treat obesity in patients. Calorie restriction is known as a successful strategy, and when combined with exercise, it can help preserve bone mineral density.

When a GLP-1 receptor agonist, particularly liraglutide in this study, is used, it speeds up the weight loss process. Alone, though, it does cause bone mineral density to decline, which can create a risk for fractures and other bone-related problems.

The analysis shows that it's best to use a combination of exercise and GLP-1 receptor agonists. This ensures more significant weight loss and preserves bone health.

Final Words

GLP-1 treatments have received a lot of attention lately as a weight loss drug. Although initially used to treat obesity in type 2 diabetes patients, some doctors prescribe it to other individuals who need to lose weight. In a new research paper, scientists reviewed evidence collected over a one-year period and found GLP-1 RA treatment can lead to bone loss. However, the loss in bone density could be prevented with exercise.

References

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820308

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10341852/