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Exploring Physical Therapy for Patients on GLP Inhibitors

By Dr. Sean Wells, PT, DPT, OCS, ATC/L, CSCS, NSCA-CPT, Cert DN

GLP Inhibitors and Physical Therapy: Preventing Bone Mass Loss 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 in June of this year. It was titled, “Can Exercise Preserve Bone Mineral Density During Weight Loss?” This study takes into consideration the new GLP inhibitors, weight loss, and the implications for exercise.

The group that was included was about 200 people, the majority of them women, about 64% women. They did not have type 2 diabetes. In this randomized control trial, all participants 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:

  • The first group received exercise.
  • The second group received liraglutide, a GLP inhibitor.
  • The third group received exercise and liraglutide.
  • The fourth was a placebo group.

Interestingly, all 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.

What were the outcomes? Well, exercise enhanced the liraglutide weight loss effects. This is similar to the information we have published earlier on this channel and my blog post. The study highlights that GLP inhibitors help patients lose weight, and exercise enhances that weight loss.

The primary outcome was that liraglutide on its own actually reduced bone mineral density. The good news is that if we focus on maintaining lean muscle mass and preventing some of that natural lean muscle mass loss through exercise, we can help preserve bone mineral density and stimulate bones, as bones respond well to forces — for example, weight-bearing, weight lifting, and resistance bands 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 semaglutide or any of these other GLP inhibitors, we need to be involved in prescribing exercises to help improve weight loss and maintain bone mineral density.

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