Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
In this randomized clinical trial, the combination of exercise and GLP-1RA (liraglutide) was the most effective weight loss strategy while preserving bone health. Liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss.
Study context
- Population
- Adults aged 18 to 65 years with obesity (BMI 32–43), without diabetes, after an 8-week low-calorie diet (800 kcal/day); Denmark, 2016–2019randomized
- Participants
- 195 adults
- Comparison
- Exercise alone vs liraglutide alone vs combination vs placebo for 52 weeks after diet-induced weight loss
- Exercisen = 48
- Liraglutiden = 49
- Combinationn = 49
- Placebon = 49reference
- Primary endpoint
- Change in site-specific bone mineral density (BMD) at the hip, lumbar spine and distal forearm, measured by DXA in the ITT population
- Follow-up
- From before the low-calorie diet to end of treatment
Methodological detailsplacebo-controlled, 4-arm, 2-centre (University of Copenhagen and Hvidovre Hospital, Denmark)
- Placebo-controlled
- 4-arm
- 2-centre (University of Copenhagen and Hvidovre Hospital, Denmark)
Primary result
As reported in the abstract
Change in BMD · end of treatment
Mean change, g/cm2 (95% CI)P value
Combinationvs Placebohip; BMD unchanged
−0.006(−0.017 to 0.004)
P = 0.24Combinationvs Placebolumbar spine; BMD unchanged
−0.010(−0.025 to 0.005)
P = 0.20Liraglutidevs Exercisehip; BMD decreased with liraglutide
−0.013(−0.024 to −0.001)
P = 0.03Liraglutidevs Exercisespine; BMD decreased with liraglutide
−0.016(−0.032 to −0.001)
P = 0.04Further findings
Total estimated mean weight loss during the study
Original publication
Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. Published 3 June 2024. doi:10.
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