If you’re a woman taking a GLP-1 medication like Ozempic, Wegovy, Mounjaro, or Zepbound, you’re probably focused on the exciting results, the weight coming off, the energy going up, the lab numbers improving. And those wins are real.
But there’s one part of your health that deserves attention while the scale is going down: your bones.
At Maze Medical Fitness Testing, we believe that smart weight loss means keeping tabs on what’s happening inside your body, not just what the mirror shows. That’s why we’re big advocates for DEXA bone density scans, especially for women using GLP-1 medications.
Here’s what you need to know.
GLP-1s Are Game Changers, But Weight Loss Affects Your Bones
GLP-1 receptor agonists (the class of drugs that includes semaglutide and tirzepatide) work incredibly well for weight loss. But any significant weight loss, whether from medication, dieting, or surgery, can lead to some degree of bone loss. It’s not unique to GLP-1s. When your body gets lighter, your skeleton experiences less mechanical loading, and bone density can decrease as a result.
A 2024 randomized trial found that semaglutide was associated with increased bone resorption (the process where bone breaks down) and measurable decreases in bone mineral density at the spine and hip after just one year of treatment. A 2026 review in the New England Journal of Medicine confirmed a roughly 1% loss of bone mineral density in the femur and spine after 52 weeks of liraglutide treatment, likely driven by enhanced bone resorption.
That doesn’t mean GLP-1s are bad for your bones. In fact, a large 2026 study in JAMA Network Open found that GLP-1 use was actually associated with lower fracture risk overall, possibly because these medications have direct protective effects on bone cells that may offset the impact of weight loss. But the picture is nuanced, and the effects may differ depending on whether you have diabetes, how much weight you lose, and your baseline bone health.
The bottom line? The bones need monitoring.
Why Is a DEXA Scan and Why Does It Matter?
A DEXA (dual-energy X-ray absorptiometry) scan is the gold standard for measuring bone mineral density. It’s quick, painless, uses very low radiation, and gives precise measurements at the spine, hip, and femoral neck, the sites most vulnerable to fractures.
But here’s what many people don’t realize: a DEXA scan also measures body composition, how much of your weight is fat, how much is lean muscle, and how much is bone. This is incredibly valuable for anyone on a GLP-1 medication, because one of the known side effects of rapid weight loss is loss of lean muscle mass along with fat.
At Maze Medical Fitness Testing, DEXA body composition scans are one of our core services. They give you a complete picture of what’s changing inside your body as you lose weight, so you and your doctor can make sure you’re losing fat, not muscle and bone.
When Should You Get a DEXA Scan?
Current guidelines from the American College of Radiology recommend DEXA screening for all women aged 65 and older, and for younger postmenopausal women with risk factors for osteoporosis. A joint advisory from the American College of Lifestyle Medicine, the Obesity Society, and other organizations specifically recommends that women on GLP-1 therapy consider DEXA scanning yearly or every two years to monitor bone density.
But if you’re losing weight rapidly on a GLP-1, waiting two years may be too long. Recent expert recommendations suggest that patients experiencing approximately 9% or more weight loss on semaglutide should have bone density and bone turnover markers checked after just one year of treatment.
Here’s a simple guide:
Before starting a GLP-1: Get a baseline DEXA scan so you know where you stand.
At 12 months: Repeat the scan, especially if you’ve lost more than 10% of your body weight.
Ongoing: Continue monitoring every 1–2 years as long as you’re on treatment.
Maze Medical Fitness Testing makes this easy. Our DEXA scans provide both bone density and full body composition data in a single visit, giving you and your healthcare provider the information needed to keep your weight loss journey safe.
What You Can Do to Protect Your Bones on a GLP-1
The good news is that bone loss during GLP-1 therapy isn’t inevitable, and there’s a lot you can do to protect yourself:
Strength train. Resistance exercise is the single best thing you can do for your bones. A recent clinical trial showed that combining GLP-1 therapy with a structured exercise program preserved bone mineral density, while GLP-1 therapy alone led to decreases. Aim for strength training at least 3 times per week.
Get enough protein. Adequate protein intake supports both muscle and bone health during weight loss. Many women on GLP-1s aren’t eating enough due to reduced appetite, so this takes conscious effort.
Don’t skip calcium and vitamin D. These are the building blocks of bone. Make sure your levels are optimized.
Stay active overall. At least 150 minutes of moderate aerobic exercise per week, in addition to strength training, is recommended.
Monitor with DEXA. You can’t manage what you don’t measure. Regular DEXA scans at Maze Medical Fitness Testing let you track your bone density and body composition over time, so you can catch changes early and adjust your plan.
The Big Picture
GLP-1 medications are among the most effective weight loss tools ever developed. For many women, they’re life-changing. But losing weight well means more than watching the number on the scale, it means making sure your bones and muscles are coming along for the ride.
A DEXA scan is one of the simplest, most informative tests you can get. It takes minutes, and the information it provides can shape your entire approach to healthy weight loss.
Ready to get your baseline? Book a DEXA scan at Maze Medical Fitness Testing today.
References
Hansen MS, Wölfel EM, Jeromdesella S, et al. Once-Weekly Semaglutide Versus Placebo in Adults With Increased Fracture Risk: A Randomised, Double-Blinded, Phase 2 Trial. EClinicalMedicine, 2024.
Rosen CJ, Ingelfinger JR. GLP-1 Receptor Agonists. New England Journal of Medicine, 2026.
Hamad CD, Wiener J, Golzar A, et al. Glucagon-Like Peptide-1 Receptor Agonists and Fragility Fracture Risk in Type 2 Diabetes. JAMA Network Open, 2026.
Ambrogini E. GLP-1 Receptor Agonists–Induced Weight Loss: Are We Paying Attention to Bone Health? Journal of Bone and Mineral Research, 2026.
Mozaffarian D, Agarwal M, Aggarwal M, et al. Nutritional Priorities to Support GLP-1 Therapy for Obesity: A Joint Advisory. American College of Lifestyle Medicine / Obesity Society, 2025.
ACR–SPR–SSR Practice Parameter for the Performance of Dual-Energy X-Ray Absorptiometry (DXA). American College of Radiology, 2024.
