ENDO 2026: semaglutide linked to 15 percent fewer fractures despite more weight loss

A new study presented at ENDO 2026, the Endocrine Society's annual meeting in Chicago, found that people with type 2 diabetes who took semaglutide had fewer bone fractures than those taking other weight-loss medications, even though the semaglutide group lost more weight ^[1]. The finding runs counter to earlier concerns that rapid weight loss on GLP-1 drugs could thin bones and raise fracture risk ^[1].

Researchers from Stanford University Medical Center looked at electronic health records for 59,879 adults with type 2 diabetes who had no prior history of fractures or osteoporosis medication use, drawing on data collected between 2016 and 2023 from U.S. hospitals and medical centers ^[1][2]. One group of 26,324 patients took semaglutide. A comparison group of 33,555 patients took dulaglutide, another GLP-1 drug, or one of two oral weight-loss medications, phentermine/topiramate or bupropion/naltrexone ^[1].

After matching patients by health characteristics, researchers followed 17,506 pairs for an average of about 1,327 days, or roughly three and a half years ^[2]. Over that time, the semaglutide group had 794 fractures, compared with 1,045 fractures in the comparison group ^[1][2]. That works out to a 15% lower rate of fractures for semaglutide users, with a hazard ratio of 0.85 (95% CI, 0.77 to 0.93; P<.001), a result unlikely to be due to chance ^[2].

The semaglutide group also lost more weight. In a separate matched analysis of 4,191 pairs, people on semaglutide saw their body mass index (BMI) drop by an average of 1.9 points, compared with a 1.2-point drop in the comparison group, with semaglutide users maintaining a lower BMI at one year ^[2]. That pattern is notable because greater weight loss has previously been linked to bone loss in some studies, the study's lead author noted ^[1].

"Bone fractures are painful, expensive and can seriously affect quality of life — especially as people get older," said Jairo Noreña, M.D., a former Stanford endocrinology fellow who led the analysis. "We hope this study encourages monitoring of bone health in weight-loss programs" ^[1].

Why it matters for patients

For people with type 2 diabetes who are choosing among weight-loss treatments, this study adds a new data point: semaglutide was linked to fewer fractures than other options studied, not more, despite producing greater weight loss ^[1][2]. That could ease some worries raised by earlier research suggesting fast weight loss on GLP-1 drugs might weaken bones ^[1].

Still, this is a retrospective look at existing health records, not a clinical trial where treatments were randomly assigned ^[1][2]. The researchers themselves say prospective studies are needed to confirm the findings before drawing firm conclusions ^[1][2]. The study also focused specifically on people with type 2 diabetes, so it is not yet known whether the same pattern would hold for people taking semaglutide for obesity alone, without diabetes.

One study author reported financial ties to biotech, pharmaceutical, or device companies, according to the disclosure attached to the research ^[2]. The findings were presented as a conference abstract and have not yet gone through full peer review and publication in a medical journal.

What happens next

The research was presented June 14, 2026, at ENDO 2026 in Chicago, which ran from June 13 to June 16 ^[2]. The study's authors are calling for prospective studies, meaning trials designed and tracked forward in time, to confirm whether semaglutide truly protects bone health compared with other weight-loss treatments ^[1][2]. No date has been set for such follow-up research, and the full study has not yet appeared in a peer-reviewed journal.