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Sources & citations

Every claim, every source

We back every clinical statement on this site with peer-reviewed research and current orthopedic guidelines. Below are the citations for the claims you’ll see across MetaOrtho.

  1. 1. Up to 40% of weight lost on GLP-1 medications can be lean muscle (and bone/connective tissue, not just fat).

    Wilding JPH et al., Once-Weekly Semaglutide in Adults with Overweight or Obesity, NEJM 2021. Rubino DM et al., JAMA 2022. Jensen MD et al., NEJM Evid 2024.

  2. 2. Long-term GLP-1 use is associated with an elevated risk of osteoporosis (~30% increase) over 5 years.

    Wajahath M et al., Long-term musculoskeletal complications of GLP-1 receptor agonists, AAOS Annual Meeting 2026.

  3. 3. Long-term GLP-1 use is associated with an elevated risk of osteomalacia (>150% increase versus matched controls in observational data).

    Wajahath M et al., AAOS Annual Meeting 2026 (small-sample observational; presented as directional evidence).

  4. 4. Long-term GLP-1 use is associated with a ~12% elevated gout risk.

    Wajahath M et al., AAOS Annual Meeting 2026.

  5. 5. Long-term GLP-1 use is associated with an elevated risk of major tendon rupture.

    Lawand A et al., AAOS Annual Meeting 2026.

  6. 6. Bone mineral density declines with significant or rapid weight loss.

    Endocrine Society and AAOS position statements on weight-loss-associated bone loss; multiple meta-analyses of bariatric and pharmacologic weight loss cohorts.

  7. 7. Resistance training during weight loss reduces the proportion of weight lost as lean mass.

    ACSM position statements; Cava E et al., Adv Nutr 2017; multiple systematic reviews.

  8. 8. Adequate protein intake (1.6–2.4 g/kg body weight per day) during active weight loss supports muscle preservation.

    Stokes T et al., Nutrients 2018. Morton RW et al., Br J Sports Med 2018. Layman DK et al.

  9. 9. Calcium and vitamin D supplementation supports bone health during weight loss.

    Endocrine Society Clinical Practice Guidelines on bone health.

About these citations

The MetaOrtho clinical team reviews this list quarterly and updates it whenever a new claim is added to the website or a stronger source becomes available. Where evidence is emerging or small-sample, we say so on the page where the claim appears as well as here.

Citations beginning “AAOS Annual Meeting 2026” refer to abstracts and presentations from the American Academy of Orthopaedic Surgeons 2026 annual meeting. Where journal publication follows, this page will be updated.

Updated 2026-04-29.