Losing weight is incredibly important when you’re obese. It helps to reduce the risk of obesity-related complications, such as type 2 diabetes and heart disease. However, calorie restriction often causes you to lose more than just fat mass, which can have a negative impact on bone health. A new JAMA Network Open paper suggests that a combination of exercise and GLP-1 medication helps preserve bone health during the weight loss process, so let’s take a look at the findings.
Study Reveals Combination Weight Loss Program Preserves Bone Health
A journal entry published on the JAMA Network, authored by S.B.K, Jensen, et al. analyzed the results that a previous randomized clinical trial recorded. The focus of the paper is to present more evidence on how bone mass can be preserved when an obese person has to lose weight.
The main objective was to compare different approaches to weight loss, including:
- Exercise alone
- The use of GLP-1 RA medication
- Combination therapy with both
Previous studies have taken a look at GLP-1 receptor agonists in the process of treating obesity. For example, a review paper in the International Journal of Molecular Sciences considered results from multiple clinical trials that focused on the use of GLP-1 agonists as a treatment for obesity in particular.
However, while many of the existing reviews focus on weight loss, along with improvements in insulin sensitivity and other metrics, there isn’t enough evidence to explain how this treatment would affect bone health.
It’s well-known that bone mass can decline with weight loss. This is why the JAMA Network journal entry is so important, as it sheds more light on this particular topic. Low bone mineral density increases the risk of fractures and injuries, especially among older individuals.
How The Trial Was Structured
The clinical trial that the researchers analyzed had 195 adult participants. All of these patients were obese at the time of the study. Bone mineral density was recorded in the forearm, spine, and hip.
This trial lasted for one year, which gave the researchers enough time to really see how these three treatment options affected the patients. Both the Hvidovre Hospital and the University of Copenhagen, situated in Denmark, were involved in the study.
The study didn’t start out with the interventions right away. Instead, all of the participants who were included in the clinical trial were first put on a calorie-restricted diet for a period of eight weeks. These individuals were allowed to eat 800 kcal per day.
After the results from the initial period were collected, the researchers then used a randomized system to divide the participants into four groups. Each of these groups had to undergo treatment over a 52-week period.
The four groups included:
- Exercise program with no other interventions. The workout routine was developed to be at a moderate to vigorous intensity level.
- Liraglutide 3.0mg per day, without any other intervention.
- A combination of 3.0mg liraglutide and the moderate to vigorous training program.
- Placebo group.
What The Researchers Found
Regular follow-ups were done to determine the efficacy of each group. In the group that only took liraglutide on a daily basis, there was a significant reduction in total body weight. However, the researchers also found that bone mineral density in the hip and spine declined in these individuals.
Bone mineral density did not significantly decline in the group that used exercise alone or combination therapy. The weight loss results were also much more significant in the combination group, with a mean weight loss of 16.88 kg. In the exercise group, the mean figure was 11.19 kg, and the liraglutide group had a mean reduction of 13.74 kg.
All of the results in terms of weight loss were more impressive than the placebo group, where the mean was only 7.03kg.
What Can We Learn From This Study
The analysis published on JAMA Network offers valuable insight into how healthcare providers should go about treating obesity in patients. Calorie restriction is known as a successful strategy and combined with exercise, it can help to preserve bone mineral density.
When a GLP-1 receptor agonist, particularly liraglutide in this study, is used, it can speed up the weight loss process. On its own, however, it was associated with lower bone mineral density at the hip and spine, which may increase fracture risk over time.
The analysis suggests that using a combination of exercise and a GLP-1 receptor agonist may be the better approach. This allows for more significant weight loss while also helping preserve bone health.
Final Words
GLP-1 RA treatments have received a lot of attention lately as weight loss drugs. These medicines were first developed for type 2 diabetes, and some later gained approval for obesity treatment as well. In this research paper, scientists reviewed evidence collected over a one-year period and found that liraglutide worked best when combined with exercise and a calorie-deficient diet.
References
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820308
