GLP-1 Drugs May Increase Osteoporosis and Gout Risk

New research finds potential side effects of popular weight loss medications

Published on Mar. 2, 2026

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According to a new study presented at the American Academy of Orthopaedic Surgeons' annual meeting, GLP-1 drugs like Ozempic and Wegovy may be linked to a slightly higher risk of osteoporosis and gout. The observational study analyzed medical records of over 146,000 adults with obesity and type 2 diabetes, finding a 30% increased risk of osteoporosis and a 12% increased risk of gout among GLP-1 users compared to non-users. Researchers theorize the rapid weight loss from these medications may deprive patients of key bone-building nutrients or change how the body builds and breaks down bone.

Why it matters

GLP-1 drugs have become increasingly popular for weight loss, but this new research suggests there may be some potential downsides to consider, particularly for older adults or those with a history of bone or joint issues. Understanding the full scope of side effects is important as these medications become more widely prescribed.

The details

The study, led by Dr. John Horneff of the University of Pennsylvania, found that about 4% of GLP-1 users developed osteoporosis compared to just over 3% of non-users. Rates of the related condition osteomalacia, or softening of the bones, were also about twice as high among GLP-1 users. For gout, 7.4% of GLP-1 users developed the condition versus 6.6% of non-users. Researchers theorize the rapid weight loss from these drugs may deprive patients of key nutrients like vitamin D and calcium, or fundamentally change how the body builds and breaks down bone.

  • The study analyzed 5 years of medical records from 2021 to 2025.

The players

Dr. John Horneff

An associate professor of orthopedic surgery at the University of Pennsylvania and the lead author of the study.

Dr. Clifford Rosen

A professor of medicine at Tufts University who has been studying the potential impact of GLP-1s on bone health, though he was not involved in this specific research.

Dr. Susan Spratt

An endocrinologist and the senior medical director for the Population Health Management Office at Duke Health in North Carolina.

Dr. Christopher McGowan

A gastroenterologist who runs a weight loss clinic in Cary, North Carolina.

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What they’re saying

“People are taking these medications, and obviously there's a tremendous amount of upside. But with that, they start to decrease their intake of food and nutrients.”

— Dr. John Horneff, Associate Professor of Orthopedic Surgery, University of Pennsylvania (nbcsandiego.com)

“Weight loss does cause bone loss. The question we've been studying is whether this is a normal compensation of the skeleton, it's just reshaping itself, or whether this is truly a risk for losing bone that's more rapid than what would be expected.”

— Dr. Clifford Rosen, Professor of Medicine, Tufts University (nbcsandiego.com)

“The takeaway isn't fear. It's refinement. Researchers who found that obesity dipped for the first time in more than a decade suggested that weight loss drugs like Ozempic might play a role.”

— Dr. Christopher McGowan, Gastroenterologist, Weight Loss Clinic (nbcsandiego.com)

What’s next

Researchers say more study is needed to fully understand the mechanisms behind how GLP-1 drugs may impact bone and joint health, and to determine if certain lifestyle factors like exercise can help mitigate any potential risks.

The takeaway

This new research highlights the need for close monitoring and guidance from healthcare providers when prescribing GLP-1 medications for weight loss, to ensure patients maintain proper nutrition and bone health during rapid weight loss. While the risks appear relatively modest, they are still important considerations for this increasingly popular class of drugs.