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[12] Several patient-specific risk factors may increase vulnerability to bone health concerns during weight loss treatment: Age : Postmenopausal women and older adults are at higher baseline risk of osteoporosis Pre-existing low bone density or previous fragility fractures Inadequate dietary calcium and vitamin D intake Sedentary lifestyle with limited weight-bearing exercise Certain medications that affect bone metabolism (e.g., corticosteroids, pioglitazone, certain anticonvulsants) Medical conditions such as coeliac disease, inflammatory bowel disease, or hyperthyroidism Smoking and excessive alcohol consumption Patients with multiple risk factors should discuss bone health monitoring with their healthcare team before starting Ozempic

Proactive care: avoiding inertia Reassessment of individual glycaemic targets and their achievement at regular intervals is key (Figs 1, 3, 4)

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