Combine GLP-1s With Exercising for Bone Health

A new study suggests that combining Saxenda and similar drugs with exercising can help keep bones strong while losing weight.

Novel type 2 diabetes and weight loss drugs called GLP-1 receptor agonists can help lose up to 20% of the body weight.

However, despite obesity being a risk factor for multiple chronic diseases, rapid weight loss can also pose health risks, including loss of bone density, which increases the risk of osteoporosis.

A new study published in JAMA Network Open suggests that the combination of exercise and liraglutide, a type of GLP-1 receptor agonist sold under the brand names of Saxenda and Victoza, is the most effective weight loss strategy while preserving bone health.

The study analyzed data from a clinical trial that included 195 adults aged 18 to 65 with obesity and without diabetes.

The participants were randomized into four groups: 48 participants in the exercise group, 49 participants in the liraglutide group, 49 participants in the group combining exercise and liraglutide, and 49 participants in the placebo group.

Those who exercised were encouraged to attend group sessions two times per week and to perform exercise individually twice per week. The group sessions consisted of 30-minute indoor cycling and 15-minute circuit training, while the most frequently performed individual exercises included cycling, running, and brisk walking.

During the one-year intervention, the participants in the placebo group lost an average of 7.03 kg, compared to 11.19 kg in the exercise group, 13.74 kg in the liraglutide group, and 16.88 kg in the combination group. Those who both exercised and took liraglutide also saw the largest body fat reduction.

Compared with the exercise group, bone mineral density decreased for the liraglutide group at the hip and spine.

Although the study emphasizes the importance of exercising while taking liraglutide, the authors note that all participants were free of chronic diseases. Therefore, the results may not be generalizable to patients with diabetes or older individuals who are at a higher risk of bone fractures.

Exercise to keep your bones healthy

Previous research in rodents and human cells has suggested that GLP-1s may have a protective effect on bone health, but the evidence in humans remains limited. The findings on using GLP-1s and the risk of fractures are also inconsistent.

Regardless of whether you use liraglutide or try to lose weight in other ways, exercising is crucial for bone and overall health.

Consider the following exercises to keep your bones healthy and prevent falls and fractures:

• Weight-bearing exercises, such as brisk walking, jogging, racket sports, and dancing.
• Resistance training exercises can involve weight machines, free weights, resistance bands, and your own body weight, such as pushups or pullups.
• Balance training, including walking wobble board, Tai chi, lunges, and step-backs.

Adults should aim for at least 150 minutes a week of moderate-intensity exercise or at least 75 minutes a week of vigorous-intensity exercise, according to Physical Activity Guidelines for Americans.

However, if you have chronic conditions, discuss the optimal amount of exercise with your healthcare provider.