Semaglutide was linked to greater weight loss and a 15% lower fracture risk in people with type 2 diabetes, raising the possibility of an unexpected bone health benefit.
People with type 2 diabetes who took semaglutide experienced greater weight loss and a lower risk of bone fractures than those using several other weight-loss medications, according to research presented Sunday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Illinois.
The study found that semaglutide was associated with a 15% reduction in fractures compared with other anti-obesity treatments. Although the findings suggest the drug may offer benefits for bone health, the researchers say prospective studies are needed to verify the results.
Weight Loss, Bone Health, and Semaglutide
Semaglutide belongs to a class of medications called glucagon-like peptide-1 receptor agonists (GLP-1s), which are commonly prescribed to treat obesity and type 2 diabetes.
Earlier research has shown that rapid weight loss with GLP-1 medications can sometimes be linked to bone thinning and a higher risk of fractures. In contrast, slower and more gradual weight loss may help preserve bone density. While scientists at Stanford University were aware that semaglutide generally produces more weight loss than older anti-obesity medications, there had been little evidence comparing its effects on bone health with those of other weight-loss drugs.
To explore that question, Jairo Noreña, M.D., former endocrinology fellow at Stanford University Medical Center in Palo Alto, California, and colleagues examined changes in body mass index (BMI) and fracture rates among adults with type 2 diabetes who were taking semaglutide, dulaglutide, or the oral weight-loss medications phentermine/topiramate and bupropion/naltrexone.
“Bone fractures are painful, expensive, and can seriously affect quality of life — especially as people get older,” Noreña said. “We hope this study encourages monitoring of bone health in weight-loss programs.”
Analysis of More Than 59,000 Patients
The researchers performed a retrospective cohort study using the Atropos Health Eos electronic health record database, which includes information from 161 million patients treated at U.S. community hospitals and academic medical centers between January 2016 and December 2023.
The analysis included adults age 18 and older with type 2 diabetes who had no previous fractures and had not used osteoporosis medications. The semaglutide group included 26,324 participants. The comparison group consisted of 33,555 people who received dulaglutide, phentermine/topiramate, or bupropion/naltrexone and had never previously used semaglutide.
Fewer Fractures and Greater Weight Loss
The results showed that people treated with semaglutide experienced larger reductions in BMI than those in the comparison group.
Researchers also found fewer fractures among semaglutide users. There were 794 fractures in the semaglutide group, compared with 1045 fractures in the control group.
“This work is an important early step toward understanding the impact of semaglutide-induced weight loss on bone health in patients with type 2 diabetes,” Noreña said.
Meeting: ENDO 2026
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