Semaglutide linked to lower bone fracture risk

In people with type 2 diabetes, semaglutide was associated with a 15% reduction in bone fractures and greater weight loss compared with other anti-obesity medications, according to a study presented at ENDO 2026, the Endocrine Society’s annual meeting in Chicago.

While these results highlight the potential bone-protective effects of semaglutide, the authors recommend prospective studies to confirm the findings.

Semaglutide is part of a group of medicines known as glucagon-like peptide-1 receptor agonists (GLP-1s), which treat type 2 diabetes and obesity. Previous studies have shown that rapid weight loss using GLP-1s can lead to thinner bones and fractures, while more moderate and slower weight loss may preserve bone mass.

Scientists at Stanford University knew semaglutide helped people lose more weight than previous generations of anti-obesity medications, but they lacked evidence comparing semaglutide’s effect on bone health with that of other anti-obesity medications.

Jairo Noreña, M.D., former endocrinology fellow at Stanford University Medical Center in Palo Alto, California, and colleagues evaluated changes in body mass index (BMI) and fracture incidence in people with type 2 diabetes taking semaglutide, dulaglutide or the oral weight-loss therapies phentermine/topiramate and bupropion/naltrexone.

“Bone fractures are painful, expensive and can seriously affect quality of life—especially as people get older,” Noreña said. “We hope this study encourages monitoring of bone health in weight-loss programs.”

The team conducted a retrospective cohort analysis using the Atropos Health Eos electronic health record dataset, representing 161 million patients seen in U.S. community hospitals and academic medical centers from January 2016 to December 2023.

Participants were adults ages 18 and older who were diagnosed with type 2 diabetes, with no history of prior fractures or use of osteoporosis medications. The intervention group received semaglutide (n = 26,324), while the control group received dulaglutide, phentermine/topiramate or bupropion/naltrexone, with no prior history of semaglutide use (n = 33,555).

The data indicated semaglutide treatment was associated with a greater reduction in BMI compared with the control group. The semaglutide group also had fewer fractures (794) than the control group (1,045).

“This work is an important early step toward understanding the impact of semaglutide-induced weight loss on bone health in patients with type 2 diabetes,” Noreña said.

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Sadie Harley

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Andrew Zinin

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