Exercise Plus Liraglutide May Preserve Bone Quality during Weight Loss: Daily Dose

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On July 3, 2024, we reported on findings from a study published in JAMA Network Open that examined bone health after diet-induced weight loss followed by a 1-year intervention with exercise, liraglutide, or both combined.

The study

Researchers conducted a secondary analysis of a study in which they randomly assigned 195 adults with obesity to receive GLP-1RA treatment (3 mg daily of liraglutide; n=49), exercise alone (n=48), a combination of exercise and liraglutide (n=49), or placebo (n=49). All participants completed an 8-week low-calorie diet before the intervention began and followed the assigned regimen for 52 weeks. Median age of the cohort was approximately 43 years, mean body mass index (BMI) 37 kg/m² and 64% were women.

For the secondary analysis, the primary outcome was change in site-specific bone mineral density (BMD) at the hip, lumbar spine, and distal forearm measured by dual-energy X-ray absorptiometry.

The findings

Results showed that participants in the group that combined liraglutide therapy with exercise had no significant changes in BMD at the hip (mean change, -0.006 g/cm²) or spine (mean change, -0.010 g/cm²) compared with the placebo group. Participants who received only liraglutide after weight loss experienced decreased BMD at the hip (mean change, -0.013 g/cm²) and spine (mean change, -0.016 g/cm²) compared with those in the exercise-only group and the placebo group (mean change, -0.019 g/cm²).

Researchers also reported that liraglutide used alone was associated with weight and fat loss vs placebo, as well as with reduced hip and spine BMD compared with placebo or exercise alone over the 52-week study period.

Authors' comment

"Our findings highlight the importance of combining exercise with GLP-1 RA treatment for bone health."

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