Episode 18: Journal Club Series | GLP-1 & GIP in Musculoskeletal Medicine: Hype or Hope?

Episode 18: Journal Club Series | GLP-1 & GIP in Musculoskeletal Medicine: Hype or Hope?

In this episode of Mind Your Body, Dr. Zev Nevo explores the surprising roles of GLP-1 and GIP beyond blood sugar control. Could these incretin hormones be the next frontier for joint health, bone healing, and musculoskeletal medicine? With engaging analogies, real-world clinical reflections, and a journal club–style review of recent research, listeners will learn what’s hype, what’s hope, and what’s still unknown. Whether you’re a patient curious about new science or a healthcare provider considering implications for your practice, this episode bridges both perspectives.

Reference: Discussion based on Journal of Advanced Research (2025), “GLP-1 and GIP Receptors: Emerging Roles in Musculoskeletal Health.”

Timestamps:

• 00:00 – Introduction & Why GLP-1/GIP Matter
• 02:20 – Key Study Reviewed (Journal of Advanced Research, 2025)
• 03:50 – What the Evidence Shows: Bones, Joints & Muscles
• 05:10 – Limitations & Critical Appraisal
• 06:45 – Clinical Reflections & Patient Examples
• 07:30 – Key Takeaways & Closing Thoughts: Thanks, reflection, and community engagement.

This essential pre-roll message serves as a clear disclaimer, stating that the podcast provides pain and trauma-informed psychoeducation for informational and entertainment purposes only, and does not constitute medical advice. Listeners are reminded to always consult a qualified healthcare professional for specific medical conditions or symptoms.

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LINKS:

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Transcript

[00:00:59] Welcome back to Mind Your Body. I'm Dr. Zev Nevo, and today we're diving into a journal club edition.

[00:01:06] If you've been following health news, you've probably heard about GLP-1, drugs like Semaglutide, also known as Ozempic, Wegovy, or Rybelsus. And Tirzepatide, also known as Mounjaro and Zepbound. They've been making headlines for diabetes and weight management. But here's the question I want us to sit with.

[00:01:27] Could these very same drugs also be helping our bones, joints, and even muscles? Hmm. Let's explore that together. So why does this matter? Well, because our bones, joints, and muscles are basically what let us live life on our own terms. Think about it. Osteoporosis doesn't just mean brittle bones on a scan.

[00:01:51] It's the fracture that keeps someone from living independently. Osteoarthritis or degenerative joint disease isn't just a diagnosis. It's the stiffness and pain that makes every step feel like work. Sarcopenia, that's the slow erosion of muscle that turns something simple like climbing stairs into a challenge.

[00:02:14] If there's even a chance that GLP-1 and GIP therapies could touch these conditions, it's worth unpacking.

[00:02:21] The study that sparked this discussion was a review published in the Journal of Advanced Research in 2025, and rather than testing one new treatment, this review gathered evidence from lots of different places, animal experiments,lab work on cells, and some early human data. The question it asked was, where are GLP-1 and GIP receptors in the body and what might they be doing beyond metabolism? Here's what stood out to me. In animal studies when GLP-1 or GIP receptors were removed, the bones were weaker and more prone to fractures. When researchers gave GLP-1 agonist bone breakdown slowed. GIP seemed to encourage new bone formation. And if you combine both, like in dual agonists such as tirzepatide, you might get less breakdown and more building.

[00:03:24] That's pretty exciting in theory. Now let's move to joints. The data here is earlier, but some preclinical studies suggest GLP-1 signaling helps reduce inflammation in cartilage and in the lining of joints. That could mean slowing down osteoarthritis, though again, that's mostly in animal models at this stage, but muscles are where the story gets more complicated.

[00:03:53] Some evidence suggests GLP-1 might help muscles use energy better, may be [00:04:00] supporting mitochondrial function, but GIP raises some concerns. Long-term activation in certain studies hinted at muscle loss, which would obviously be a big red flag when we think about sarcopenia. And what about actual human data?

[00:04:18] Some observational studies found people on GLP-1 therapies had better bone density or fewer fractures. Others didn't see much difference at all. And here's the kicker. None of these trials were designed to measure bone, joint, or muscle outcomes. They were diabetes or weight loss trials and musculoskeletal effects were more of a side observation.

[00:04:42] So it's suggestive, but not definitive. This brings me to what I think is the heart of the discussion. How do we hold both the promise and the limitation at the same time? For patients, the idea of one treatment that can help blood sugar, weight, [00:05:00] bones, joints, and maybe even muscle is incredibly appealing, but we can't rush ahead of the evidence.

[00:05:07] Every medication comes with risks and the science here is still very young. For providers, the challenge is a little different. Could GLP-1 or GIP agonists one day be part of post-fracture care. Could they help slow arthritis progression? Could they support aging adults trying to preserve muscle and independence?

[00:05:30] Possibly. But until we have randomized control trials with these outcomes as the primary focus, we have to view all of this as hypothesis, not fact. I like to use the Swiss Army knife analogy. These drugs started with one blade diabetes, then another unfolded weight loss, then another cardiovascular protection, and now maybe musculoskeletal health.

[00:05:57] But with any multi-tool, the question isn't just what else can it do? It's also how well does it do each of these jobs and when should we actually use it? In clinic, I've had some patients tell me, doctor, I feel stronger since I started this medication.

[00:06:14] Others suffer from side effects such as autonomic dysfunction, brain fog, physical fatigue, or loss of interest in things that previously brought them pleasure. That might be placebo. It might be a byproduct of weight loss, or maybe it's an early clue of a real effect on bone and muscle biology.

[00:06:37] We don't know yet, but these stories matter just as much as lab results. They're lived experiences that deserve to be part of the conversation. 

[00:06:48] Here's the bottom line.

[00:06:50] GLP one and GIP receptors show up in bone cartilage and muscle. Animal and early human studies suggest there's potential to protect and strengthen these tissues. But human evidence is still limited and inconsistent. Until we have well-designed trials, 

[00:07:08] it's a space to watch with interest and for providers, it's a frontier that deserves attention, curiosity, and a critical eye. And that's where I'll wrap up today's Journal Club edition of Mind Your Body. Science evolves and so does healing. Thanks for being here with me as we sort through the hype and the hope.

[00:07:28] Until next time, take care of your mind and body.