Does Ozempic Cause Bone Loss? What the Labels and Studies Show, Especially for Women

Ozempic is a prescription medicine that contains semaglutide. Novo Nordisk makes it, and it is FDA-approved for adults with type 2 diabetes. Wegovy, also from Novo Nordisk, contains semaglutide too and is approved for weight reduction and other uses. Whether semaglutide affects bone is a question that the labels and a growing set of studies answer in different ways. This guide sets them side by side.

Label quotes come from DailyMed, read on September 30, 2026: the Wegovy label revised 6/2026, the Ozempic label revised 5/2026 and the Zepbound label revised 8/2026. Study quotes come from each study's published abstract, or from the Epic Research brief itself. Quotes are word for word, and the labels print brand names in capital letters. This page does not reprint doses or strengths.

*Key takeaways*

• There is no settled answer yet. Label safety reports, bone density trials and fracture studies point in different directions.
• The Wegovy label reports that in its cardiovascular outcomes trial, "more fractures of the hip and pelvis were reported on WEGOVY than on placebo in female patients", and in patients 75 and older (Wegovy label, section 6.1).
• The Ozempic label text has no fracture entry. A search of the full text on September 30, 2026 found none (Ozempic label).
• Weight loss itself can affect bone. A 2025 review describes "high turnover bone loss" after significant weight reduction through calorie restriction or surgery (Karam and colleagues).
• The U.S. Preventive Services Task Force recommends osteoporosis screening for women 65 or older, and for postmenopausal women under 65 at increased risk, using a DXA bone density test (USPSTF, 2025).

What the Wegovy label's adverse reactions section says, word for word (section 6.1, revised 6/2026): "In the CV outcomes trial in adults, more fractures of the hip and pelvis were reported on WEGOVY than on placebo in female patients: 1% (24/2,448) vs. 0.2% (5/2,424), and in patients ages 75 years and older: 2.4% (17/703) vs. 0.6% (4/663), respectively."

The same section 6.1 paragraph reports a second trial, in adults with MASH (metabolic dysfunction-associated steatohepatitis, a liver condition that is among Wegovy's labeled uses). There, fractures occurred at "2.6 cases per 100 patient years" with Wegovy compared with "2 cases per 100 patient years" with placebo, and "Fractures were reported in both males and females with a median age of 61 years (range, 44 to 75)."

Does Ozempic cause bone loss?

The evidence is mixed, and no source cited here establishes that Ozempic causes bone loss or that it does not. Semaglutide is the active ingredient in Ozempic and Wegovy, but the two are approved for different uses, and their label trials enrolled different people. Three kinds of evidence exist so far:

• Label safety reports. The Wegovy label reports more hip and pelvis fractures on Wegovy than on placebo in women and in adults 75 and older in one trial. The Ozempic label text does not mention fractures.
• Bone density trials. In a small trial, bone density at the spine and hip was lower with semaglutide than with placebo after 52 weeks (Hansen and colleagues).
• Fracture studies in large groups. Results run both ways: one cohort of older adults with type 2 diabetes found a modest increase in fragility fractures with GLP-1 medicines (Kasher Meron and colleagues), while a meta-analysis of trials in type 2 diabetes concluded that GLP-1 medicines "could reduce the risk of fracture in T2DM patients" (Zhang and colleagues).

The table further down lists each study with its population and limits.

What does the Wegovy label say about fractures?

The fracture paragraph quoted above sits in section 6.1 of the Wegovy label, "Clinical Trials Experience". In plain numbers: 24 of 2,448 women taking Wegovy and 5 of 2,424 women taking placebo had a hip or pelvis fracture reported, and among patients 75 and older, 17 of 703 on Wegovy and 4 of 663 on placebo. Section 8.5 repeats the point for older adults: "In the CV outcomes trial, patients aged 75 years and older reported more hip and pelvis fractures in the WEGOVY injection-treated patients than placebo-treated patients."

The trial is Study 1 in section 14.1 of the label (NCT03574597), which the ClinicalTrials.gov record titles "SELECT - Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity". The label describes the trial as enrolling "adults with established CV disease and either obesity or overweight", states that "All patients were 45 years or older", and adds: "Patients with a history of type 1 or type 2 diabetes were excluded."

Two points of reading matter here. First, fractures were not the trial's goal; the label states that "Safety data collection was limited to serious adverse events (including death), adverse events leading to discontinuation, and adverse events of special interest." Second, "reported more" is an observation from one trial. The label does not state that Wegovy causes fractures, and it gives no explanation for the difference.

The Ozempic label, revised 5/2026, has no fracture entry: a search of its full text on September 30, 2026 for "fracture", "bone mineral", "bone density" and "osteoporosis" found none. Ozempic's approved population is adults with type 2 diabetes, a group the Wegovy trial excluded. A missing entry means the label does not report a finding; it does not show that there is no effect.

Why can weight loss affect your bones?

Weight loss by other means can affect bone too. A 2025 review in Osteoporosis International by Karam and colleagues states that significant weight reduction "through calorie restriction, with or without exercise, and bariatric/metabolic surgery results in high turnover bone loss." On GLP-1 medicines, the same review concludes that "preliminary findings indicate that GLP-1Ra causes modest bone mineral density reduction and enhances bone remodeling, favoring resorption similar to the effects of calorie restriction, further research is needed on fracture-related outcomes in people living with obesity."

The authors of the semaglutide bone trial read their own result the same way: "The observed increase in bone resorption in the semaglutide group may be explained by the accompanying weight loss" (Hansen and colleagues). Low body weight is also one of the osteoporosis risk factors the USPSTF lists.

What do the studies show?

Each row gives the population in the same line as the finding, because a result in older adults with diabetes does not automatically apply to a 50-year-old woman without it.

Read together, the bone density trials lean toward some loss of bone density alongside weight loss, and the fracture studies in people with type 2 diabetes point in both directions. None of them settles the question for Ozempic in particular.

Why are women after menopause at higher risk?

Age and menopause are fracture risk factors on their own, whether or not someone takes a GLP-1 medicine. The USPSTF lists the main risk factors: "These include menopausal status, low body weight, parental history of hip fracture, cigarette smoking, and excess alcohol consumption." It also notes: "Although bone density is an important risk factor for fragility fractures, advancing age is a stronger determinant." And it explains why: "Older adults have much higher fracture rates than younger adults with the same BMD because of concurrent increasing risk from declining bone quality and an increasing risk of falling."

The Bone Health and Osteoporosis Foundation puts the scale in one line: "Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis."

The groups the Wegovy label names, female patients and patients 75 and older, overlap with these risk groups. For a woman after menopause, the practical question is where her own bones stand before and during treatment.

Should you get a bone density test?

The USPSTF recommendation, dated January 14, 2025, gives two grade B recommendations for women:

• "The USPSTF recommends screening for osteoporosis to prevent osteoporotic fractures in women 65 years or older."
• "The USPSTF recommends screening for osteoporosis to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk for an osteoporotic fracture as estimated by clinical risk assessment."

For men, it found the evidence insufficient: "The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men." On the test itself, it notes that "screening includes dual energy X-ray absorptiometry (DXA) bone mineral density (BMD), with or without fracture risk assessment".

The USPSTF recommendation does not mention GLP-1 medicines (search of the recommendation page, September 30, 2026). Whether starting one changes when you should be screened is a question for your clinician, using your age, menopause status and other risk factors.

Can you protect your bones while taking a GLP-1 medicine?

One randomized trial tested exercise directly. In the trial by Jensen and colleagues, adults with obesity took liraglutide, followed an exercise program, did both, or took placebo for a year after a low-calorie diet. The results: "In the combination group, BMD was unchanged compared with the placebo group at the hip" and lumbar spine, meaning no difference from placebo, while "Liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss." Liraglutide is a different GLP-1 medicine from semaglutide, so this result may not transfer directly to Ozempic.

This page does not give nutrition amounts or supplement advice. If you are eating less, ask your clinician whether your calcium, vitamin D and protein intake is enough. For keeping lean mass during weight loss, see GLP-1 muscle loss, and for life after treatment, see how to keep weight off after GLP-1.

Should you stop Ozempic because of bone loss?

Not on your own. None of the sources on this page tells people to stop semaglutide because of bone concerns, and the medicine was prescribed for a reason. Bring the question to the clinician who prescribes it. These questions can help:

1. Given my age, menopause status and history, do I meet the USPSTF criteria for a DXA scan, and should I have one before or during treatment?
2. Do I have other risk factors for fracture, such as low body weight, a parent's hip fracture, smoking, alcohol use or corticosteroid medicines?
3. How much weight am I losing, and could that affect my bones?
4. What kind of strength or weight-bearing exercise is safe for me?
5. Is my calcium, vitamin D and protein intake enough?
6. What about my fall risk at home?
7. If a scan shows low bone density, what are the options, and does it change my GLP-1 treatment?

For what the Wegovy label's clinical studies section reports, see Wegovy results. For other effects listed in a GLP-1 label, see Zepbound side effects.

What the primary sources say

• Novo Nordisk via DailyMed, Wegovy (semaglutide) prescribing information, revised 6/2026 (accessed September 30, 2026): section 6.1, "In the CV outcomes trial in adults, more fractures of the hip and pelvis were reported on WEGOVY than on placebo in female patients: 1% (24/2,448) vs. 0.2% (5/2,424), and in patients ages 75 years and older: 2.4% (17/703) vs. 0.6% (4/663), respectively."; section 8.5, "patients aged 75 years and older reported more hip and pelvis fractures in the WEGOVY injection-treated patients than placebo-treated patients."
• Novo Nordisk via DailyMed, Ozempic (semaglutide) prescribing information, revised 5/2026 (accessed September 30, 2026): no entry for fracture, bone mineral density or osteoporosis in the label text.
• Eli Lilly and Company via DailyMed, Zepbound (tirzepatide) prescribing information, revised 8/2026 (accessed September 30, 2026): no entry for fracture, bone mineral density or osteoporosis in the label text.
• U.S. Preventive Services Task Force, Osteoporosis to Prevent Fractures: Screening, January 14, 2025 (accessed September 30, 2026): "The USPSTF recommends screening for osteoporosis to prevent osteoporotic fractures in women 65 years or older."
• Bone Health and Osteoporosis Foundation, What is Osteoporosis and What Causes It? (accessed September 30, 2026): "Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis."
• Karam L and colleagues, Osteoporosis International 2025;36(11):2115-2126 (accessed September 30, 2026): "The impact of glucagon-like peptide-1 receptor agonists (GLP-1Ra) on bone health remains unclear."
• Hansen MS and colleagues, eClinicalMedicine 2024;72:102624 (accessed September 30, 2026): "Compared to placebo, lumbar spine and total hip areal bone mineral densities (aBMD) were lower in the semaglutide group after 52 weeks"
• Jensen SBK and colleagues, JAMA Network Open 2024;7(6):e2416775 (accessed September 30, 2026): "Liraglutide treatment alone reduced BMD at clinically relevant sites more than exercise alone despite similar weight loss."
• Kasher Meron M and colleagues, Journal of Clinical Endocrinology and Metabolism 2026;111(7):1949-1958 (accessed September 30, 2026): "Initiating GLP-1RA therapy was associated with a modestly increased risk of fragility fractures in older adults with type 2 diabetes."
• Zhang Y and colleagues, Bone 2025;192:117338 (accessed September 30, 2026): "Due to the limited nature of contemporary research, further studies are needed to develop a clear clinical consensus."
• Epic Research, March 3, 2026 (accessed September 30, 2026): "Among adults with type 2 diabetes, osteoporosis risk was lower for patients prescribed a GLP-1 than for patients who were not prescribed a GLP-1".

Every source is listed with its address below.

This article is for informational purposes only and does not constitute medical advice. Label sentences are quoted word for word from the FDA-approved prescribing information named above, as published on DailyMed on September 30, 2026, and study findings are quoted from the published abstracts or, for Epic Research, the published brief. Labels and evidence change, so talk with your clinician before starting, stopping or changing any medicine or supplement.

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