Does Ozempic^® Cause Bone Loss?

Key takeaways:

• Taking Ozempic^® may cause some bone density loss, but it’s likely from weight loss, not Ozempic^® itself.

• So far, there isn’t a link between Ozempic^® and an increased risk of fractures or osteoporosis.

• Protect your bones during weight loss with strength training and by getting enough calcium, vitamin D, and protein.

Ozempic^® (semaglutide) is a once-weekly injection that can help people with type 2 diabetes manage their blood sugar levels. It can also help folks with overweight and obesity lose weight. You might have heard rumors about the drug’s negative effects on bones.

Does Ozempic^® cause bone loss? There’s no evidence linking Ozempic^® directly to bone loss or osteoporosis. However, significant weight loss — which can happen when you take Ozempic^® — may cause a loss in bone density.

Ahead, we’ll go over what we know so far about Ozempic^® and bone loss, plus how to protect your bones when taking the medication.

More research is needed to know whether Ozempic^® can cause bone loss. Some studies show a link between Ozempic^® and lower bone density (osteopenia). But this may be due to the weight loss Ozempic^® can cause rather than the medication itself.

Research on Ozempic^® Bone Density Loss

A small 2024 study looked at people with an increased risk of bone fractures — mostly women after menopause. Half of the participants took a 0.5 milligram (mg) dose of Ozempic^® and the other half took a placebo for a year.

By the end of the study, there were no differences in bone formation — the process of making new bone — between the Ozempic^® group and the placebo group.

However, bone mineral density in the lower spine and hip was lower in the Ozempic^® group. This could indicate weaker bones. Also, a marker of bone resorption — a natural part of bones breaking down — was higher in the Ozempic^® group.

Researchers concluded that this could be due to weight loss rather than Ozempic^® itself.

Research is mixed, though. A systematic review looked at glucagon-like peptide-1 receptor agonists (GLP-1s), the class of medication Ozempic^® belongs to. It found that GLP-1 medications didn’t affect bone mineral density and weren’t linked to increased fracture risk.

Ozempic^® and Osteoporosis

Research hasn’t found a link between Ozempic^® and osteoporosis, a condition that causes weak and brittle bones.

A clinical trial on Wegovy^® — which contains a higher maximum dose of semaglutide — found an increased fracture risk in women and older adults. Fractures are still rare, though. They were reported in 1 percent of women and 2.4 percent of people over age 75 taking the medication.

How Weight Loss Affects Your Bones

Any changes to your bones on Ozempic^® might come down to weight loss.

Losing a significant amount of weight reduces mechanical loading — the stress placed on your bones that can strengthen them.

During a weight loss journey, you might also get fewer nutrients and not enough protein, calcium, or vitamin D — all of which are needed for healthy bones. Hormonal changes can influence bone density as well.

Finally, you might lose muscle mass along with fat mass, and bone mineral density is linked to muscle mass.

You can protect your bones while losing weight on Ozempic^® by eating nutritious foods with enough calcium, vitamin D, and protein. Strength training and losing weight gradually can help too.

Let’s discuss these tips in more detail.

1. Get Enough Calcium, Vitamin D, and Protein  

As you’re losing weight, make sure you’re getting enough nutrients to maintain bone health. That includes calcium, vitamin D, and protein.

You can get calcium from:

• Low-fat milk, yogurt, and cheese

• Fortified soy products

• Salmon

• Spinach

• Kale

• Fortified milk alternatives

You can get vitamin D from:

• Salmon

• Low-fat milk

• Low-fat yogurt

• Mushrooms

• Fortified milk alternatives

Your body can also make vitamin D from the sun, but you might still need a vitamin D supplement during the winter if you can’t get enough from your diet.

A healthcare professional can let you know if you should take a calcium or vitamin D supplement. Supplements might be useful if you’re vulnerable to bone loss. For instance, women have a higher risk of osteoporosis during and after menopause.

Protein is important for maintaining and building muscle, which can help preserve bone density and muscle strength.

High-protein foods include:

• Chicken

• Turkey

• Fish

• Eggs

• Tofu

• Lean beef

• Greek yoghurt

→ Learn more: High-Protein Foods for Weight Loss

2. Strength-Train

Research on Saxenda^® — a GLP-1 drug like Ozempic^® — found that taking Saxenda^® and exercising maintained bone density during weight loss. And taking Saxenda^® alone led to reduced bone density.

Weight-bearing exercises like walking and jogging are useful. But strength training is particularly beneficial for preserving bone mass.

Strength training can both prevent bone density loss during weight loss and increase bone density. This includes heavy resistance training and jump training that puts stress on your bones.

Strength training also prevents muscle loss and can build more lean mass, which can help you preserve bone density.

Aim for at least two strength-training sessions a week. Your workouts can incorporate: 

• Bodyweight exercises, like squats, lunges, crunches, and push-ups 

• Dumbbells, kettlebells, and resistance bands

• Weight lifting

• Resistance machines in the gym 

• Jump-training exercises, like squat jumps, burpees, and box jumps 

→ Learn more: Strength Training for Beginners

3. Lose Weight Gradually

Rapid weight loss is linked to a loss of bone density. Slower weight loss is less likely to affect your bones.

The Centers for Disease Control and Prevention (CDC) recommends losing about 1 to 2 pounds a week.

Losing weight gradually can help your body adapt to weight loss, preserve muscle, and help you maintain weight loss in the long run.

Ozempic^® and other weight loss medications can improve your health in many ways, but one concern is the possible adverse effects on bones. More research is needed on the potential Ozempic^® side effect of bone density loss.

Here’s what to keep in mind.

• Ozempic^® may cause some bone loss. It’s unclear if this is down to the medication or the significant weight loss it can cause. (Weight loss can cause some bone loss.)

• Ozempic^® isn’t linked to osteoporosis or fracture risk. More research is needed, but so far, Ozempic^® isn’t linked to more bone fractures or osteoporosis.

• Protect your bones while losing weight. Eat enough calcium, vitamin D, and protein, and strength-train regularly — including heavy resistance training or jump training.

• Slow, steady weight loss is generally best. Losing weight gradually can help prevent bone loss.

Considering Ozempic^®? Take our free online weight loss assessment to find out if Ozempic^® — or another weight loss drug — is right for you.

See answers to frequently asked questions about Ozempic^® bone density concerns.

Is Ozempic^® hard on bones?

More research is needed to know if Ozempic^® is hard on bones. Some studies show that people may lose some bone density on Ozempic^®, but this could be due to weight loss, not the drug itself.

Does Ozempic^® cause osteoporosis?

It’s unclear if Ozempic^® causes osteoporosis. More research is needed. Some research shows lower bone density after taking Ozempic^®, but this may be due to weight loss rather than the drug itself.

How to prevent osteoporosis when taking Ozempic^®?

You can prevent osteoporosis and keep bones healthy while taking Ozempic^® by eating enough calcium, vitamin D, and protein. Doing regular strength-training exercises can help too.

Should I take calcium with Ozempic^®?

You might benefit from taking calcium with Ozempic^®, especially if you’re vulnerable to bone loss. Calcium supplementation may help reduce bone density loss as you lose weight. Reach out to a healthcare provider to find out if you should take calcium while on Ozempic^®.