Every drug comes with its trade-offs, including blockbuster weight loss medications like semaglutide (the active ingredient in Ozempic) and other GLP-1s. To hear the internet tell it, though, GLP-1s are basically rotting users from the inside out.
Myths and misconceptions about GLP-1 drugs have grown rampant on social media as of late. The drugs are supposedly doing everything from wasting away bones to destroying people’s sense of joy. These myths aren’t flatly wrong, though—they’re a distraction from the nuanced conversations we should be having about these important but far from miraculous therapies.
No, Ozempic is not shredding bones
The latest iteration of GLP-1 misinformation revolves around bones.
People are claiming on social media that the drugs can commonly “shred” bone, based on a misreading of a real, if preliminary, study. The research, presented last month at the annual meeting of the American Academy of Orthopedic Surgeons, found that GLP-1 use was associated with higher rates of osteoporosis (bone weakening) and osteomalacia (bone softening).
Leaving aside that this study hasn’t yet gone through the typical peer review process, there’s some very important context here. For starters, the absolute rates of osteoporosis and osteomalacia were low, even in the GLP-1 group (4.1% and 2%, respectively). And other research has suggested that the increase in these risks comes from the weight people lose while taking a GLP-1, rather than the drug directly.
Even the study researchers themselves don’t call for people to abandon their GLP-1s. Instead, they argue that doctors should monitor the bone health of users at higher risk of these complications, since there are easy things you can do to prevent them proactively, like taking more vitamin D and calcium or strength training. Interestingly enough, a separate study presented at the same conference found that GLP-1 use might reduce the risk of post-operative side effects in people undergoing common orthopedic surgeries.
Oh, and the viral image attached to this latest bit of fearmongering (seen above)? No idea where it’s actually from, but it has squat to do with the study.
Other kinds of misfortune blamed on GLP-1s are based on even more flimsy evidence. As Gizmodo has covered before, for instance, there’s next to little data supporting that these drugs are sapping people’s muscles. People will lose some lean body mass when losing weight, no matter how it’s done. And as with our bones, you can take steps to mitigate potential muscle loss if you’re really worried about it, such as increasing your protein intake.
Other zombie GLP-1 myths linger despite most relevant research having refuted it.
It’s true, for instance, that some health agencies were worried about Wegovy increasing people’s suicide ideation soon after it hit the market in 2021. However, these agencies investigated the matter more extensively and ultimately found no connection. A study published just this month found that semaglutide use was actually associated with a lower risk of worsening depression, anxiety, and substance use disorders.
Risks and benefits
To be clear, this isn’t me saying GLP-1s are all reward and no risk.
These drugs very commonly cause unpleasant gastrointestinal side effects, though you can take steps to mitigate them. And while scientists are constantly finding new potential health benefits of GLP-1s, they’re finding new possible risks, too.
Several studies have shown that GLP-1s can increase the odds of certain eye conditions, for instance. While the overall risk of these eye issues seems to be very rare, it’s still vital to know about that risk so doctors and patients can prevent or treat them appropriately. And this might not be the last unpleasant surprise we learn about GLP-1s, if history is any teacher.
There isn’t really a free lunch in medicine. Most anything that can positively change the body can sometimes backfire in ways we do and don’t expect. Even my regular jogs have occasionally resulted in me spraining my ankle or coming home with scrapes and bruises from an accidental fall.
A drug works when its benefits outweigh the risks on average for the people who most need it. So far, that has proven abundantly true for those taking GLP-1 therapy to treat their type 2 diabetes, obesity, and maybe someday, their substance use disorder or other form of addiction.
It’s always important to understand the benefits and risks of any medical treatment and for people (ideally with the help of their doctors) to decide for themselves whether the former merits taking on the latter. That’s harder to do when the internet is rife with misinformation about the most well-known drugs this side of Viagra. So as annoying as it is to see undying memes about Ozempic sucking away people’s skeletons or whatnot, it remains worthwhile to debunk them.
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