GLP Inhibitors have been all the rage this past year. These medications offer people significant weight loss, which can help them get off medications and feel better. These drugs have been controversial for their potential link with muscle mass loss, but this happens with any form of weight loss (especially when resistance training is not done simultaneously). Now, new research is showing that GLP inhibitors may also pose a risk for another area of our bodies — our bones! Fortunately, there is a natural and positive way to address this potential negative effect of these great drugs.

The article is by Jensen et al., and it was published in JAMA Open Networks June of this year. It was titled, Can Exercise Preserve Bone Mineral Density During Weight Loss. This study is it takes into consideration the new GLP inhibitors, weight loss, and obviously the implications for exercise. The group that was included was about 200 people, majority of them women, about 64% women. They did not have type 2 diabetes. And in this randomized control trial, all the participants, they all consumed a low-calorie

diet for eight weeks.

All participants were tracked and followed twice during that eight-week period by a dietician. The 200 participants were assigned to one of four different groups:

1. The first group received exercise.

2. The second group received liraglutide, that's a GLP inhibitor.

3. The third group was exercise and liraglutide.

4. And the fourth was a placebo group.

Now, interestingly, all of those in the exercise group received two group exercise sessions per week. They were also required or asked to do two sessions on their own. These group sessions included 30 minutes of cycling and 15 minutes of circuit training, which was described as vigorous aerobic exercise plus some resistance training. Now, exactly how the exercise was dosed, I don't really know. And how quickly or accurately they were followed on their own, that remains to be seen. But regardless, the liraglutide group started at a dose of 0.6 milligrams per day and was increased up to about three milligrams per day to their tolerance.

So what were the outcomes? Well, exercise enhanced the liraglutide weight loss effects. This is similar to the stuff that we published earlier on this channel and on my blog post and in my courses that GLP inhibitors help patients to lose weight. Exercise enhances that weight loss.

Secondly, the real big outcomes that I kind of primary outcome was that liraglutide on its own actually reduced bone mineral density. And that bone mineral density loss makes sense because again, with weight loss, we lose muscle mass, we lose mass in general.

Bones respond to that, right? And they obviously will lose some of their bone density as well. If we're able to focus on maintaining lean muscle mass and preventing some of that natural lean muscle mass loss through exercise, then we maybe can maintain bone mineral density and also stimulate bones because bones respond well to forces, right? Compressive forces through weight bearing, weight lifting, bands, and holding exercises can help mitigate these losses!

Our expert doctors of physical therapy can prescribe those exercises for you or your loved one. If you or a loved one is on liraglutide or semiglutide or any of these other GLP inhibitors, we need to be involved in prescribing exercises to help improve weight loss as well as maintain bone mineral density.

Call us today for a free phone consultation for PT in Naples, Ponte Vedra, or Jacksonville at: 904-568-1156