Side Effects of GLP-1 Medications, Like Ozempic and Mounjaro, Could Result in Bone Density Loss: Study

A combination of both GLP-1 medications and exercise were needed to achieve weight loss without also losing bone density, researchers found.

A new study warns that the side effects of Ozempic, Wegovy, Mounjaro and similar diabetes and weight loss medication can result in a loss of bone density; the latest in a growing number of concerns linked to the drugs, which are rising in popularity.

Ozempic (semaglutide) was initially introduced for the treatment of people with Type 2 diabetes in late 2017, as part of a new class of medications known as glucagon-like peptide-1 receptor agonists (GLP-1 RAs). However, amid aggressive advertisements that promoted the weight loss benefits, Ozempic has been increasingly prescribed as a diet drug in recent years, making it a blockbuster treatment that is now used by millions of Americans.

As a result of the popularity of Ozempic for weight loss, Novo Nordisk has introduced a higher dose version under the brand name Wegovy, which is specifically approved as a diet drug. However, it contains the same active ingredient.

Eli Lilly has also introduced two competing drugs that are part of the same GLP1-RA class; including Mounjaro (tirzepatide), which was approved for diabetes treatment in 2022, and a weight loss version of the drug approved by the FDA last year, marketed under the brand name Zepbound.

Although advertisements promote the drugs as safe and effective, with few long-term side effects, GLP1 RAs have been linked to a number of potentially serious health risks, including a form of stomach paralysis, known as gastroparesis, in which food lingers in the stomach, leading to a number of different health complications.

As a result of the drug makers’ failure to adequately warn about this risk, thousands of former users are now pursuing Ozempic lawsuits, Wegovy lawsuits and Mounjaro lawsuits against the manufacturers, each raising similar allegations that the manufacturers placed a desire for increased profits above consumer safety by failing to research and disclose side effects users may experience.

In this latest study, a team of researchers from the University of Copenhagen in Denmark point to another potential side effect of GLP1 use that is not fully described on the drug label, including potential bone density loss and the critical importance of combining exercise with use of the diet drugs.

In findings published this week in the medical journal JAMA Network Open, Dr. Simon Birk Jensen and other researchers outlined data from a randomized clinical trial, which looked at bone health in certain relevant areas of the body, such as the hip, spine and forearms, among individuals who used the older GLP-1 diabetes drug Victoza (liraglutide) for at least a one-year period. The study involved 195 participants between the ages of 18 and 65 from August 2016 to November 2019.

Some patients received Victoza, while others received a placebo. Some tried to lose weight through exercise alone, and others received Victoza while following an exercise regimen. According to the findings, the highest overall weight loss was seen in participants who both took Victoza and exercised. Those given Victoza alone had the next highest weight loss, followed by patients who only exercised and patients who received a placebo.

However, those given Victoza alone saw a decrease in bone mineral density (BMD), the researchers noted, in both the hips and spine.

“In this randomized clinical trial, the combination of exercise and GLP-1RA (liraglutide) was the most effective weight loss strategy while preserving bone health,” Jensen and his team concluded. “Liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss.”

The researchers indicate their findings highlight the importance of combining GLP-1 treatment with exercise.

GLP-1 Failure to Warn Lawsuit

Amid the launch of newer GLP-1 medications like Ozempic, Wegovy, Mounjaro and Zepbound, and the rapid adoption of the drugs for weight loss, there have been serious questions raised about whether the drug makers adequately disclosed all of the potential serious long-term risks that users may experience.

While gastrointestinal side effects are mentioned on the drug label, lawsuits allege that the risks were minimized on the drug label, and the drug makers failed to adequately disclose the permanent and long-term damage that may result from stomach paralysis caused by GLP-1 drugs.

In October 2023, a study was published that found GLP1s triple the risk of the stomach paralysis among users when compared to users of non-injectable weight loss drugs, igniting a rapid rise in litigation against the drug makers.

Given common questions of fact and law raised in complaints brought throughout the federal court system, the U.S. Judicial Panel on Multidistrict Litigation established coordinated pretrial proceedings for all GLP-1 RA drug lawsuits, centralizing claims brought throughout the federal court system in the Eastern District of Pennsylvania, for coordinated discovery and pretrial proceedings.  

As part of the coordinated management of the growing litigation, it is expected that the parties will identify a small group of “bellwether” cases to prepare for early trial dates, which will help help gauge how juries may respond to certain evidence and testimony that will be repeated throughout the claims. However, if the parties are unable to negotiate GLP1 settlements or another resolution for the litigation following any early test trials, each individual lawsuit may later be remanded back to the U.S. District Court where it was originally filed for a separate trial date in the future.