Does Ozempic Cause Bone Density Loss?

Ozempic is classified as a glucagon-like peptide-1 receptor agonist (GLP-1 RA, often simply called GLP-1s). GLP-1 agonists replicate the natural hormone (GLP-1) to prompt the pancreas to dispense insulin into the bloodstream after eating.

Insulin works by reducing the amount of sugar in the blood. With diet and exercise, semaglutide (the active ingredient in Ozempic) can help people manage blood sugar and lose weight.

Ozempic also delays how quickly food moves from the stomach to the intestines, curbing hunger and potentially aiding in weight loss. However, Ozempic is approved to treat type 2 diabetes — not chronic weight management. Its sister drug, Wegovy, is approved for weight loss.

Numerous side effects can come about after using Ozempic or another semaglutide off-label for weight management.

Bone density, also known as bone mass, measures how much calcium and other minerals the bones contain. Bones with more minerals are denser, stronger and less prone to breaking. To assess your bone health and risk for fracture, a doctor may perform a bone mineral density (BMD) test. These tests measure your bone density compared to that of a healthy individual of your age.

As you age, your bones naturally lose density. However, loss of bone mass can also result from a family history of low bone mass, certain medical conditions, tobacco and alcohol use, lack of exercise and taking certain medications.

Recent research found that participants who took GLP-1 RAs without exercise experienced bone density loss in their hips and spine. Those who combined exercise and GLP-1 RAs were more likely to maintain bone health while losing weight.

Yes, despite not being a listed side effect, GLP-1 RA drugs like Ozempic may cause bone density loss when not used in conjunction with a healthy diet and exercise. A June 2024 clinical study published in JAMA Network examined the effects of liraglutide (another GLP-1 RA drug) and exercise on bone density.

All study participants went on a prescribed low-calorie diet for eight weeks. Those who lost at least 5% of their starting body weight were then randomly assigned to one of four groups:

1. A placebo group
2. A group that adhered to a moderate- to vigorous-intensity exercise program only (exercise group)
3. A group that received a daily liraglutide dosage only (liraglutide group)
4. A group that participated in the exercise program and took liraglutide (combination group)

The participants adhered to these group guidelines for 52 weeks (1 year). The researchers then compared the starting and finishing BMDs of the 195 participants. They found:

• Average weight loss: The average change in weight for the placebo group was 7.03 kilograms, 11.19 kilograms for the exercise group, 13.74 kilograms for the liraglutide group and 16.88 kilograms for the combination group.
• BMD changes: Researchers measured BMD at three key areas: the hip, the lumbar (lower) spine and the forearm. They found that compared to the placebo group, the combination group didn’t see a change in BMD at the hip and lumbar spine. But compared to the exercise group, the liraglutide group experienced a BMD decrease at the spine and hip.

The researchers determined “the combination of exercise and GLP-1 RA (liraglutide) was the most effective weight loss strategy while preserving bone health.” They also reached the conclusion that “liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss.”

Does Ozempic cause osteoporosis?

There may be a connection between Ozempic and osteoporosis, though it’s not disclosed on the drug’s warning label. Ozempic use may cause osteoporosis because losing weight very quickly can result in bone density loss. Osteoporosis makes bones weak and brittle, causing them to break even when mildly stressed.

People with osteoporosis or prone to it should be cautious when taking medications like Ozempic that can reduce bone density. Rapid weight loss affects calcium absorption and can diminish strength and endurance in older people. However, moderate weight loss combined with exercise isn’t believed to harm bone health.

Does Ozempic cause sarcopenia?

Research indicates that GLP-1 RA drugs might be linked to sarcopenia — a condition that results in a loss of muscle mass, strength and endurance. Although most people begin slowly losing muscle after turning 30, sarcopenia dramatically speeds up this process.

One 2021 study concluded that GLP-1 RA medications like Ozempic may increase the risk of sarcopenia because they help people lose weight by decreasing calorie intake and increasing blood sugar elimination through urine, reducing muscle mass. Glucose-lowering drugs can also impact the body’s protein balance, further contributing to sarcopenia.

Using medications like Ozempic without maintaining a healthy diet or exercising can lead to sarcopenia and bone density loss. This risk is not disclosed on the drug’s warning label.

Sarcopenia typically affects the elderly, but people of all ages who lose weight quickly while taking GLP-1 RA drugs may be at risk. In older individuals, sarcopenia can lead to a greater likelihood of cognitive issues, disabilities and death. Along with adversely affecting bone health, sarcopenia damages an individual’s quality of life by impacting their energy and capacity to perform daily activities like chores or housework.

Before you take a semaglutide medication like Ozempic, talk with your doctor about the risks and side effects. Semaglutide may not be safe for everyone.

People who use Ozempic should speak with their doctor about how they can combat bone density loss. Combining exercise with Ozempic use can be effective for losing weight and maintaining bone health. Behavioral changes like eating more protein and engaging in strength and weight training can help prevent the depletion of bone and muscle mass associated with using GLP-1 RA drugs.

Our law firm represents patients who became seriously ill and endured dangerous side effects after taking prescribed medications like Ozempic. If you or someone you love experienced severe symptoms in connection with these diabetes and weight loss drugs, our attorneys have the knowledge and resources to help you obtain justice. We can help you:

• Investigate whether Ozempic might be the cause of your osteoporosis, sarcopenia or other side effects
• Review whether Novo Nordisk failed to warn you about potential on- and off-label side effects connected with Ozempic
• Build and file a legal case if you’re a good candidate for an Ozempic lawsuit

Read more on our medical drug experience.

Don’t stop taking a prescribed medication without first consulting your doctor. Discontinuing a prescribed medication without your doctor’s advice can result in injury or death. Ozempic, Wegovy and Rybelsus remain approved by the U.S. Food and Drug Administration.