The multi-billion dollar weight loss drug revolution, built on glucagon-like peptide-1 receptor agonists (GLP-1Ra), has been marketed as a metabolic breakthrough for the nearly 900 million adults worldwide living with obesity. But buried beneath the headlines of dramatic weight reduction and cardiovascular benefits lies a troubling clinical reality that patients and prescribing physicians were never fully warned about: these drugs are quietly dismantling bone architecture, accelerating bone turnover that favors resorption over formation, and may be setting up a significant portion of the millions taking these medications for an increased fracture risk that industry-sponsored trials conveniently failed to emphasize.
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