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Practical Recommendations for Clinicians Given the inconclusive data on bone safety during GLP1 treatment, clinicians should: Assess fracture risk using tools like FRAX before starting therapy Order BMD tests for patients with osteoporosis risk factors Monitor for excessive or rapid weight loss that may compromise bone mass Promote calcium and vitamin D intake, resistance training, and fall prevention strategies Refer to endocrinologists or bone specialists as needed for complex cases Future Research Questions Several questions remain unanswered about how GLP1 medications influence longterm bone integrity: Do individual GLP1 agents differ in their effects on bone remodeling

doi: 10.2147/ndt.S420475 120 KoskuviMMalwadeSGracias LekanderJHrbeckEBrunoSHolmen LarssonJet al

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