Wellness
Weight-loss jabs may worsen bone health in menopausal women
Experts warn weight-loss jabs such as Wegovy and Mounjaro could worsen bone health in menopausal women already at risk of osteoporosis.
Dr Jack Mosley, son of the late broadcaster and health advocate Michael Mosley, said the treatments may carry hidden side-effects for women with fragile bones.
The drugs mimic GLP-1, a natural hormone that increases insulin, slows digestion and reduces appetite. While trials show strong weight-loss results, rapid weight reduction can worsen osteoporosis – a condition that leaves bones brittle and prone to fracture.
Speaking on The Dr Louise Newson Podcast, Dr Mosley said: “We know one of the risks of GLP-1s is that a significant amount of the weight you lose is muscle or lean body mass… 25–40 per cent of the weight you lose is body mass.
“And a main component of that is muscle. And muscle is so important for longevity and living healthy independent life in later age.
“I do also have some concerns it could, in certain people who aren’t eating the right nutrition, it could actually potentially exacerbate things like osteoporosis in menopausal women.
“That period around menopause and perimenopause, your hormones completely change and the decline in oestrogen and testosterone and progesterone can have big effects on you, especially in body composition… muscle loss can accelerate and other things like osteoporosis. So we really need to approach them with knowledge and care.”
Dr Mosley said GLP-1 drugs were “powerful” but “not magic bullets” in the battle against obesity.
Common side-effects include nausea and diarrhoea, with some patients developing serious complications such as pancreatitis or allergic reactions.
Dr Martin Whyte, associate professor of metabolic medicine at the University of Surrey, said it was “not proven” that GLP-1s themselves reduce bone mineral density.
“In fact, some studies suggest these drugs may have protective effects on bone,” he said.
“Major trials found no increased risk of fractures. However, a key complicating factor is that weight loss – regardless of the cause – can increase the risk of low bone density, especially when it occurs rapidly.
“This happens because weight loss reduces the mechanical load on bones and alters the hormonal signals that regulate bone maintenance. Regular exercise, by increasing mechanical load, can help counteract the effects of weight loss on bone health.”
Around 1.5m Britons are now paying privately for weight-loss jabs, while NHS provision remains limited.
The drugs have also gained celebrity endorsement, with former tennis champion Serena Williams appearing in an advertising campaign.
Dr Mosley raised concern over a lack of awareness about the risks: “People are not provided with information about these medications.
“They are very effective but a lot of people don’t understand the risks and rewards, the side effects and how to manage them.”
Stephen Lawrence, a GP and associate clinical professor at the University of Warwick, said GLP-1 drugs were “powerful medical tools with clear benefits for some, but also real risks, especially muscle loss and potential nutritional problems, if used without lifestyle changes or medical oversight.”
“They are much more than magic bullets and should be approached thoughtfully, respecting both their potential and their limits,” he said.
“Menopause is a time of significant metabolic change, and while GLP-1 medications and hormone therapy both have roles in managing weight and health for women in this phase, they are most effective and safest when used as part of a broader lifestyle plan that includes exercise and nutritional support.
“Individualised care and evidence-based medical advice should always guide choices around these medications.”
Professor Lawrence added that women accessing the drugs on the black market faced greater risks.
Dr Mosley clarified that he was “not for or against” weight-loss jabs, adding: “They can be really beneficial for certain people, who are living with obesity and have tried a lot of these other dietary options. It is very difficult for some people.”
Manchester City has launched a female athlete health platform covering menstrual, pelvic and breast health, as well as nutrition.
The Her City website is designed for the club’s women’s first-team players, coaches, support staff, academy players and parents.
Manchester City says the platform is the first of its kind in the Women’s Super League and was developed over two years.
The project was led by director of performance services Emma Deakin, physical performance scientist Rosie Anderson and PhD student and first-team nutritionist Sarah Malone.
It grew out of PhD research into menstrual, pelvic and breast health and nutrition, with the team seeking to turn that work into an online educational resource.
The website divides the four areas into separate sections and provides peer-reviewed information that the club says has been critically analysed by experts.
Content will continue to be reviewed and updated as further evidence emerges.
Resources include posters, visual explainers, audio materials and downloadable educational content, with information tailored to different groups including players and parents.
The platform aims to improve knowledge, develop critical analysis skills and strengthen communication within football and at home.
It also includes material to help users assess misinformation they encounter on social media or elsewhere.
A confidential contact form allows users to raise concerns or ask questions directly of experts at Manchester City.
Parents of academy players can also access the platform, with resources intended to help them support their children during a key phase of their development.
Manchester City said its longer-term aim is to make the platform available to all women working across City Football Group.
Small bowel microbiome differences between women and men may help explain why some conditions are more common in women, a study suggests.
The small bowel microbiome is the community of microorganisms living in this part of the digestive tract, where they play vital roles in immune function, metabolism and hormonal regulation.
Researchers found differences between women and men in the composition and organisation of these microbial communities. One bacterial community containing Granulicatella was found only in women.
The study was conducted by investigators at Cedars-Sinai Health Sciences University.
Ruchi Mathur, director of clinical research and clinical operations for the Medically Associated Science and Technology (MAST) Program at Cedars-Sinai and corresponding author of the study, said: “One intriguing finding was a bacterial community containing Granulicatella, which we found only in women.
“Bacteria in this community appear at increased levels in women with polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome.”
The researchers also identified differences between women and men in how microbes in the small bowel produce fructans, complex carbohydrates known to trigger digestive symptoms in irritable bowel syndrome (IBS).
IBS is far more common in women than men.
Mathur, who is also a professor of medicine, said: “Our findings show that biological sex is a critical variable in the small bowel microbiome.
“We must consider it as we move toward more personalised approaches to understanding and treating disease.”
Weight loss surgery was linked to more regular periods and fewer polyendocrine metabolic ovarian syndrome (PMOS) symptoms in women aged 18 to 45 living with obesity in a recent study.
The researchers recommend that women undergoing the procedure have access to preconception care and reproductive counselling to support their reproductive health.
Researchers at the University of Surrey analysed data over 24 months from 84 women who underwent bariatric surgery and 18 women living with obesity who did not have surgery.
Of those who underwent surgery, 49 had gastric bypass procedures and 35 had gastric sleeve surgery.
Women who underwent metabolic bariatric surgery lost more than 30kg on average at 12 and 24 months after the procedure.
Among women with polycystic ovaries, the condition persisted in only 10 per cent after 24 months.
Women also reported a resolution of clinical hirsutism, or excess body hair, by 12 months.
Women who had previously experienced irregular periods reported more regular menstrual cycles after surgery.
Professor Martin Whyte, co-author of the study and professor of metabolic medicine at the University of Surrey, said: “A large proportion of those undergoing bariatric surgery are women of reproductive age, who may be planning a pregnancy in the coming years.
“So much remains unknown about the impact of this type of surgery on women who are planning to have children.
“This raises the question of when the ideal time after surgery is to conceive.”
Women have a higher prevalence of obesity than men, with 57 per cent of women in the UK classified as overweight and 27 per cent living with obesity, which can affect fertility and the health of an unborn baby.
The researchers said 17 women had healthy pregnancies following surgery.
Although this was not specifically examined in the study, no difference in birth weight was observed between babies conceived within or after the first year.
Dr Kathryn Hart, co-author of the study and associate professor in nutrition and dietetics at the University of Surrey, said: “What we have found is that bariatric surgery positively affects the reproductive health of women living with obesity and can improve the likelihood of them having a healthy pregnancy after surgery.
“Dysregulated hormone levels, irregular periods and conditions such as polycystic ovaries are affected by obesity.
“By reducing this, what we have seen is that it can lead to improvements without the need for medication.
“We would suggest that clinicians consider medical intervention for obesity to treat irregularities in the menstrual cycle and issues with fertility.”
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