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What is less often discussed is what those changes mean for your gut microbiome and your nutritional intake over time

Nevertheless, bone consequences of intentional weight loss interventions in PwO are well known: (i) significant weight loss induced by caloric restriction and bariatric surgery results in accelerated bone turnover and bone loss, and (ii) unlike caloric restriction interventions, PwO experience a substantial deterioration in bone microarchitecture and strength associated with an increased risk of fracture after bariatric surgery especially malabsorptive procedures

Multiple randomized controlled trials and meta-analyses in patients with type 2 diabetes and obesity demonstrate that GLP-1RA therapy either preserves or modestly increases bone mineral density (BMD) at key skeletal sites lumbar spine and hip, GLP-1RAs also favorably modulate bone turnover markers, increasing bone formation markers (P1NP, osteocalcin, bone-specific alkaline phosphatase) and reducing bone resorption markers (-CTX), suggesting a net positive or neutral effect on bone remodeling

They work by mimicking the effects of the naturally occurring hormone called glucagon-like peptide-1 (GLP-1), which is responsible for regulating insulin and blood sugar levels