Do GLP-1 Weight Loss Drugs Affect Bone Healing After Leg Fracture Surgery? | Research

The takeaway

Large retrospective study of GLP-1 RA users undergoing leg fracture surgery found clinical outcomes with two-year follow-up, though the effects on fracture healing remain controversial.

275,970 patients matched
One of the largest studies examining GLP-1 RA effects on fracture healing outcomes

What the researchers found

Large propensity-matched retrospective analysis compared perioperative GLP-1 RA users with non-users following lower extremity fracture fixation with two-year follow-up.

Why it matters

Millions of GLP-1 RA users may need fracture surgery. Knowing whether these drugs impair or help bone healing is critical for surgical planning and medication management decisions.

The numbers in context

275,970 patients analyzed. 6,125 propensity-matched pairs. Matched on age, sex, tobacco, diabetes, hypertension, hyperlipidemia, heart disease, lung disease, and BMI. Higher nonunion rate in GLP-1 group at 1 year.

How the study worked

Retrospective propensity-matched cohort study from a large multicenter database, comparing GLP-1 RA users (within one year of surgery) versus non-users after lower extremity fracture fixation.

Who was studied

Patients undergoing lower extremity fracture surgery, comparing GLP-1 users to non-users

What this study cannot tell us

Retrospective design — cannot prove causation. GLP-1 RA users may differ from non-users in ways not captured by propensity matching. Specific fracture types and healing metrics vary.

How to read the evidence

Large retrospective cohort study with propensity matching — strong for observational data but cannot replace a randomized trial for establishing causation.

When this study was published

Published in 2025, addressing a timely concern as GLP-1 RA prescribing continues to expand rapidly.

The bigger picture

This is one of the largest studies addressing the GLP-1 RA and bone health question, which is increasingly relevant as these drugs are prescribed to a broader population that includes elderly and fracture-prone patients.

Questions still open

Should GLP-1 RAs be paused before fracture surgery?
Do the potential bone-protective effects of weight loss counterbalance any direct drug effects on bone healing?

Common questions

Do GLP-1 drugs weaken bones?

The evidence is controversial. Some studies suggest GLP-1 RAs may have bone-protective effects, while others raise concerns about fracture healing. This large study provides important real-world data on actual surgical outcomes.

Should I stop my GLP-1 medication before fracture surgery?

This is a decision to make with your orthopedic surgeon and endocrinologist based on the latest evidence. This study helps inform that discussion by providing outcome data from a large patient population.

Read the original research

Perioperative glucagon-like Peptide-1 receptor agonist use and clinical outcomes following lower extremity fracture fixation: A large retrospective cohort study with two year follow up.

Injury, 56(11), 112746

View on PubMed ↗Publisher’s paper ↗

Citation

Pereira, Daniel E; Tummala, Sri; Mittal, Mehul M; Obey, Mitchel; Berkes, Marschall B; McAndrew, Christopher M; Wilson, Jenna L. (2025). Perioperative glucagon-like Peptide-1 receptor agonist use and clinical outcomes following lower extremity fracture fixation: A large retrospective cohort study with two year follow up.. Injury, 56(11), 112746. https://doi.org/10.1016/j.injury.2025.112746