PT Is a Must for Bone Density with GLP Inhibitors

If there is only one thing you take away from this video today it's that GLP inhibitors can promote weight loss, which also promotes bone density loss -- which PT prescribed exercise can prevent from happening! Enjoy the video (transcript below), here's the article, and if you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60!

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Transcript

Hey y'all, Dr. Wells here from Nutritional Physical Therapy. I'm here with another research update with St. Augustine Beach, Florida. What a great day today.

Anyhow, this article is by Jensen et al., and it was published in JAMA Open Networks June of this year. It was titled, Can Exercise Preserve Bone Mineral Density During Weight Loss? What I love about this study is it takes into consideration the new GLP inhibitors, weight loss, and obviously the implications for exercise. Well, overall, the group that was included was about 200 people, majority of them women, about 64% women.

They did not have type 2 diabetes. And in this randomized control trial, all the participants, they all consumed a low-calorie diet. That's important, for eight weeks.

And that was tracked and followed twice during that eight-week period by a dietician. And they were assigned in that group, or sorry, in this cohort, they were assigned four different groups. The first group received exercise.

The second group received liraglutide, that's a GLP inhibitor. The third group was exercise and liraglutide, so basically combining those two. And the fourth was a placebo group.

Now, interestingly, all of those in the exercise group received two group exercise sessions per week. And then they were required or asked to do two on their own. These group sessions included 30 minutes of cycling and 15 minutes of circuit training, which was described as vigorous aerobic exercise plus some resistance training.

Now, how exactly that was dosed, I don't really know exactly. And how quickly or accurately they were followed on their own, that remains to be seen. But regardless, the liraglutide group started at a dose of 0.6 milligrams per day and was increased up to about three milligrams per day to their tolerance.

So what were the outcomes? Well, exercise enhanced the liraglutide weight loss effects. This is similar to the stuff that we published earlier on this channel and on my blog post and in my courses that GLP inhibitors help patients to lose weight. Exercise enhances that weight loss.

So we as physical therapists and exercise specialists, we need to be advertising this from the top of the mountain. Secondly, the real big outcomes that I kind of primary outcome was that liraglutide on its own actually reduced bone mineral density. And that bone mineral density loss makes sense because again, with weight loss, we lose muscle mass, we lose mass in general.

Bones respond to that, right? And they obviously will lose some of their muscle density as well, or excuse me, bone density as well. If we're able to focus on maintaining lean muscle mass and preventing some of that natural lean muscle mass loss through exercise, then we maybe can maintain bone mineral density and also stimulate bones because bones respond well to forces, right? Compressive forces. As PTs, we can do that.

We can prescribe those exercises. So we need to be, again, preaching from the top of the mountain that if your patient's on liraglutide or semiglutide or any of these other GLP inhibitors, we need to be involved in prescribing them exercises to help improve their weight loss as well as maintain their bone mineral density. Anyhow, hope you like this.

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Keywords: GLP-1 inhibitors, weight loss, exercise, bone mineral density, liraglutide, muscle mass, physical therapy, randomized controlled trial, RCT