GLP-1 weight loss drugs could increase risk of osteoporosis and gout, new research finds

Taking popular GLP-1 class weight loss drugs like Ozempic and Wegovy could be linked to a higher risk of developing osteoporosis, gout and a condition that causes severe bone softening compared to people who don’t use the medications, researchers said Monday.

An analysis using five years of medical records from tens of thousands of adults diagnosed with obesity and Type 2 diabetes showed “statistically significant increases” of the conditions, the American Academy of Orthopedic Surgeons said in a statement.

The risk of the degenerative bone disease osteoporosis rose by about 30 percent percent, and the risk of the bone softening condition osteomalacia occurred about twice as often among people on the drugs. There was also a 12 percent higher rate of gout for people on GLP-1s.

The research was presented Monday at the academy’s annual meeting in New Orleans, Louisiana, and has not yet been published in a peer-reviewed journal.

The findings indicate that the effects of the medications needed to be monitored closely, the researchers said, stressing that changes could be made to help fight and potentially prevent these effects.

Osteoporosis and gout are common in older adults – already affecting tens of millions of American adults – but osteomalacia is considered to be less common.

“Any medication that sees this rapid adoption warrants close examination, particularly in orthopedics where obesity and surgical intervention often overlap, and when the long-term effects of GLP-1 RA exposure on bone and joint health remain poorly understood,” Muaaz Wajahahth, a fourth-year medical student at Michigan State University College of Human Medicine, said.

The study was observational, so the researchers can’t prove that the medications caused these conditions. It is unknown whether or not the patients included in the analysis maintained a healthy diet and exercise regimen, which can help mitigate bone density loss.

Still, the findings follow previous research that linked the drugs to a higher risk of osteoporosis-related fractures in older adults with Type 2 diabetes and reduced bone density.

The Food and Drug Administration label for semaglutide – the active ingredient in many weight loss drugs – says it may increase the risk of bone fractures in older adults and women.

Women are more likely to suffer from bone fractures than men because they have smaller and thinner bones and the bone-protecting hormone estrogen decreases sharply during menopause, according to the Bone Health & Osteoporosis Foundation.

Although more research is needed to understand if GLP-1 drugs affect bone health, experts have expressed concern that people taking the appetite-suppressing shots and pills don’t get enough nutrients, including the bone-building vitamin D.

Rapid weight loss can also lead to muscle loss, which has been linked to osteoporosis and bone density.

It may also be possible that the weight loss changes how the body builds and breaks down bone, Dr. John Horneff, an associate professor of orthopedic surgery at the University of Pennsylvania and the lead author of the study, told NBC News.

Rapid weight loss can lead to a temporary spike in the waste product uric acid – created when the body breaks down chemicals called purines in food and drinks – that raises the risk of gout, he said.

Gout already affects more than nine million Americans. The form of arthritis is more common in older people and men, who have higher levels of uric acid in their bodies. It can also be caused by genetic factors, obesity, high blood pressure and kidney disease. There is no cure, but it can be treated with anti-inflammatory medication.

There is also no cure for osteoporosis, which affects some 10 million Americans and is the most common bone disease.

Tied to genetic history, age, gender, size and chronic health conditions such as autoimmune disease or endocrine disorders, degenerative condition may lead to an increased risk of fractures and can result in losing height, shortness of breath and changes in posture, according to the Cleveland Clinic.

Doctors recommend staying active or taking special medication to strengthen existing bone tissue and slow bone density loss.

Osteomalacia, the condition that softens and weakens the bones, occurs when people don’t have enough vitamin D, calcium or phosphate to keep the bones strong, according to Penn Medicine. It is treated by correcting these deficiencies and is often curable or reversible.

The condition has been uncommon in the U.S. since milk was fortified with vitamin D in the 1930s. Now, it affects approximately one in 1,000 people, according to the educational orthopedic surgery company Ortho Bullets.