A recent secondary analysis found that combining exercise with glucagon-like peptide-1 receptor agonist therapy preserved bone mineral density at key sites during weight loss in adults with obesity.
"Weight loss–induced bone loss likely carries a risk across the lifespan, and identifying treatments that induce clinically relevant weight loss while minimizing bone loss is essential in long-term obesity management," noted study investigators in JAMA Network Open.
Following an initial 8-week low-calorie diet (800 calories/day), 195 adults aged 18 to 65 were randomized to 1 of 4 groups for a 52-week intervention: exercise alone, 3 mg of liraglutide alone, a combination of both, or placebo. Of the study patients, 124 were female and 71 were male, with a mean age of 42.8.
Bone mineral density (BMD) at clinically relevant sites—the hip, spine, and forearm—was measured before and after the intervention using dual-energy x-ray absorptiometry.
Despite weight loss, the combination group maintained BMD at the hip (mean change, −0.006 g/cm²) and spine (−0.010 g/cm²), whereas the liraglutide group experienced reductions in BMD at the hip (−0.013 g/cm²) and spine (−0.016 g/cm²).
Weight loss was highest in the combination group (16.88 kg) compared to the placebo (7.03 kg), exercise alone (11.19 kg), and liraglutide alone (13.74 kg) groups.
The study did not look at adults with other chronic diseases, which was considered a limitation. However, the heterogenous nature of the study enhances the applicability of the study results, noted the investigators.
Full disclosures can be found in the published study.