The study presented at the Endocrine Society’s annual meeting in Chicago in June 2026 reported that among people with type 2 diabetes, those taking semaglutide experienced 794 bone fractures compared with 1,045 fractures in a control group using other anti-obesity medications. This corresponds to a 15% lower fracture risk linked to semaglutide use, according to a press release from the Endocrine Society. The semaglutide group also showed a greater reduction in body mass index (BMI) than the comparator group, officials said.

Among people with type 2 diabetes, those taking semaglutide experienced 794 bone fractures compared with 1,045 fractures in a control group using other anti-obesity medications.

The research, presented as part of ENDO 2026, focused on fracture incidence rather than direct measures of bone mineral density or bone quality. Details about the study’s design were limited in the press release, and the findings do not establish causation but suggest a potential association between semaglutide use and reduced fracture risk relative to other weight-loss drugs, the society noted.

Additional studies provide a mixed picture of semaglutide’s effects on bone health. A retrospective cohort study published earlier in 2026 found that adults with obesity using semaglutide had a 26% lower fracture risk compared with those undergoing sleeve gastrectomy, with a hazard ratio of 0.74 and a 95% confidence interval of 0.56 to 0.98. The authors of that study described the result as indicating a possible bone-protective effect of semaglutide relative to surgical weight-loss treatments.

Conversely, a 2024 randomized trial involving adults at increased fracture risk found that semaglutide did not increase bone formation and was associated with higher bone resorption, a process that may be explained by weight loss, according to the study’s authors. That trial also reported decreases in lumbar spine and total hip areal bone mineral density after 52 weeks in the semaglutide group compared with placebo.

Weight loss itself is increasingly recognized as a factor that can compromise skeletal integrity. A 2025 review in Nature Reviews Endocrinology highlighted that rapid or sustained weight loss can reduce bone mineral density and increase fracture risk. Supporting this, a 2025 advance article in the Journal of Clinical Endocrinology & Metabolism (JCEM) reported that use of semaglutide or tirzepatide was associated with greater annualized total-hip bone loss in patients without diabetes. That study found a significant association between weight loss and bone loss at the total hip and femoral neck.

Further, a 2024-2025 Endocrine Society abstract documented significant declines in lumbar spine, femoral neck, and total hip bone mineral density among patients receiving semaglutide or tirzepatide, with total-hip decline linked to the amount of weight lost.

Not all research shows a fracture risk reduction with GLP-1 receptor agonists like semaglutide. A recent JCEM cohort study of older adults with type 2 diabetes reported an 11% increased fracture risk among new GLP-1 receptor agonist users compared with comparator therapies, with a hazard ratio of 1.11 and a 95% confidence interval of 1.01 to 1.21. In that study, GLP-1 receptor agonist use was associated with higher fracture risk than dipeptidyl peptidase-4 (DPP-4) inhibitors but not clearly higher than sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Another study in people with obesity but without diabetes found that GLP-1 receptor agonists were linked to increased fracture risk, with fracture incidence rates of 3.05% in exposed patients versus 2.61% in unexposed patients. That study also reported a stronger fracture risk signal in individuals with a body mass index over 40 and among older age groups.

The Endocrine Society’s June 2026 report compared semaglutide specifically with other anti-obesity medications rather than placebo. Prior research indicates that the effects of semaglutide and other GLP-1 receptor agonists on bone may vary depending on diabetes status, the amount of weight loss, and the comparator treatment used. Some data suggest that semaglutide may have a relatively favorable profile compared with bariatric surgery, which is known to negatively affect bone health. However, other datasets show either no clear bone benefit or a small increase in fracture risk, reflecting inconsistency in the literature.

The findings presented at ENDO 2026 add to a complex body of evidence regarding semaglutide’s impact on bone health. The reported 15% fracture risk reduction and fracture count differences provide important data points but do not confirm a protective effect on bone. Further research, including peer-reviewed studies with detailed methodology and longer follow-up, will be necessary to clarify semaglutide’s role in skeletal health among people with type 2 diabetes and obesity.

The FDA said it recently seized dozens of units of counterfeit Ozempic (semaglutide) injection 1 mg that had been distributed illegally outside Novo Nordisk’s authorized supply chain in the United States. The agency emphasized that it cannot verify the identity, quality, safety, or effectiveness of the seized counterfeit products, which may pose serious health risks to patients. Officials urged patients, wholesalers, retail pharmacies, and health care professionals not to use, distribute, or sell Ozempic products matching the identified counterfeit lot and serial numbers.

The counterfeit vials reportedly bear real lot numbers combined with illegitimate serial numbers, a key indicator of falsification, according to FDA and Novo Nordisk.

One cluster of counterfeit products carried the authentic lot number PAR0362 paired with serial numbers beginning with “51746517,” which the companies identified as illegitimate. Authorities clarified that the lot number PAR0362 alone is genuine, but any product with this lot number and serial numbers starting with “51746517” is counterfeit and unsafe. In a separate enforcement action, the FDA reported counterfeit Ozempic labeled with lot number NAR0074 and serial number 430834149057, and instructed stakeholders not to distribute, use, or sell products bearing this exact combination.

FDA and Novo Nordisk advised pharmacies and patients to carefully inspect labels, packaging, and device components, including verifying lot and serial numbers against FDA notices, as a primary method to detect suspect counterfeit semaglutide products. The agency also recommended obtaining semaglutide injections only through state-licensed pharmacies with valid prescriptions and warned against purchasing from unverified online sources.

While the FDA acknowledged receiving adverse event reports associated with the authentic lot through Novo Nordisk, officials said none of the reported events appeared directly linked to the identified counterfeit units as of the agency’s notice. However, because the contents and concentration of the counterfeit semaglutide are unknown, the FDA and Novo Nordisk warned that these products could result in ineffective treatment, under-dosing, or overdosing, all of which carry health risks, especially for patients with diabetes or obesity. Some seized counterfeit products included counterfeit needles, raising concerns about sterility and the potential for infection or transmission of blood-borne pathogens. Both the FDA and Novo Nordisk emphasized that neither entity can confirm the ingredients, sterility, or manufacturing conditions of the counterfeit injections, making any use potentially dangerous.

The FDA specifically highlighted that the seized counterfeit Ozempic entered the U.S. market outside Novo Nordisk’s authorized distribution channels, with online sellers and other unauthorized outlets identified as key concerns for counterfeit distribution. Novo Nordisk warned retail pharmacies and individuals to purchase Ozempic and other semaglutide products only through authorized distributors and cautioned that purchases from unverified online pharmacies increase the risk of receiving counterfeit products. The FDA discouraged consumers from buying prescription semaglutide without a valid prescription or at unusually low prices online, describing such offers as potential indicators of counterfeit medicines. The agency also urged reporting of suspected counterfeit or tampered medicines sold online through its criminal activity reporting channels.

The FDA is continuing its investigation into counterfeit Ozempic in the legitimate U.S. drug supply chain and has seized thousands of units as part of a broader enforcement effort. The agency is working closely with Novo Nordisk and federal partners to identify, investigate, and remove suspected counterfeit semaglutide products from the market. The investigation involves extensive visual examination and chemical testing to determine the composition, quality, and potential health risks of the seized products. The FDA said its investigation is ongoing and that it will update public safety communications as new counterfeit lots, serial numbers, or distribution channels are identified.

Novo Nordisk issued its own safety communication on April 14, 2025, confirming the distribution of “several hundred units” of counterfeit Ozempic 1 mg outside its authorized supply chain in the U.S. The company reiterated that lot number PAR0362 is authentic but stressed that products combining this lot with serial numbers starting with “51746517” are counterfeit and must not be used. Novo Nordisk advised retail pharmacies to validate their shipments using lot and serial number details and other authentication tools, and urged patients to inspect their Ozempic boxes and pens and to contact the company’s customer care line at 1-800-727-6500 or the FDA if they suspect their product may be counterfeit. The manufacturer supported the FDA’s efforts to remove counterfeit products from the supply chain due to the significant safety risks posed by unverified injections.

The FDA instructed patients, pharmacists, and clinicians to check all Ozempic 1 mg inventory for the specified counterfeit lot and serial number combinations and to quarantine any suspect products. Suspected counterfeit Novo Nordisk products can be reported directly to the FDA as suspected criminal activity through the agency’s reporting portal or local consumer complaint coordinators. Health care professionals and consumers are encouraged to report adverse events or product quality problems related to both suspected counterfeit and legitimate Ozempic products to the FDA’s MedWatch program. The FDA and Novo Nordisk also advised reporting websites selling counterfeit or tampered medicines to help enforcement efforts target illicit online operations. Patients concerned about the authenticity of their semaglutide products were directed to contact their pharmacist, prescriber, Novo Nordisk customer care, and the FDA and to stop using any product suspected to be counterfeit until its authenticity is verified.

The approval marks the first time the FDA has authorized an oral glucagon-like peptide-1 (GLP-1) receptor agonist specifically for weight management in adults, officials said. The FDA’s decision was based on data from the OASIS 4 clinical trial, which included 307 participants randomized in a 2:1 ratio to receive either the 25 mg semaglutide oral tablet or placebo, alongside lifestyle interventions involving diet and physical activity, according to Novo Nordisk. The trial’s 64-week treatment period incorporated a 12-week dose escalation protocol, with participants achieving an average weight loss of approximately 17% if they remained on the 25 mg dose throughout the study. When accounting for all participants regardless of adherence, the average weight loss was about 14%, company records show.

Participants achieving an average weight loss of approximately 17% if they remained on the 25 mg dose throughout the study.

The OASIS 4 trial excluded individuals with diabetes and included a seven-week off-treatment follow-up phase, according to the FDA’s review documents. The safety profile observed was consistent with known semaglutide side effects, including gastrointestinal symptoms such as nausea, vomiting, diarrhea, constipation, and abdominal pain, the agency noted. Reports of altered skin sensation were more frequent at higher doses but generally resolved over time, officials added. The FDA has issued a boxed warning highlighting the risk of thyroid C-cell tumors based on rodent studies, although the relevance to humans remains unknown, according to prescribing information.

Novo Nordisk plans to launch the oral Wegovy tablet in the United States in early January 2026, with an initial 1.5 mg starting dose priced at $149 per month, company representatives confirmed. The 25 mg once-daily dose will be available following the dose escalation period outlined in the clinical trial. The tablets are produced domestically in the U.S., ensuring a robust supply at launch, according to company sources. Novo Nordisk emphasized that concomitant use of oral Wegovy with other semaglutide products or GLP-1 receptor agonists is not recommended due to potential safety concerns and lack of additional benefit, the FDA prescribing information states.

Timothy Garvey, MD, a professor at the University of Alabama at Birmingham, commented on the approval, saying it equips healthcare professionals with more options to tailor weight management treatments for patients. “Oral Wegovy expands the delivery formats of semaglutide, providing additional flexibility for patients and clinicians,” Garvey said in a statement provided by Novo Nordisk. The company highlighted that the approval broadens patient choices in managing excess weight and underscores the ability to meet diverse patient needs with efficacious therapies.

Wegovy is indicated for adults with obesity or overweight who have at least one weight-related comorbidity, such as hypertension or type 2 diabetes, and is intended to be used in conjunction with a reduced-calorie diet and increased physical activity, according to FDA labeling. The medication is also approved to reduce the risk of major cardiovascular events in certain adults and carries an accelerated approval for treating metabolic dysfunction-associated steatohepatitis (MASH) with fibrosis. Healthcare providers are advised to monitor blood glucose levels in patients with diabetes before and during treatment with Wegovy tablets.

The FDA’s approval of the oral semaglutide tablet adds to the existing portfolio of semaglutide products, which includes injectable formulations previously approved for weight management and diabetes treatment. The original approval for Wegovy injection dates back to 2017, and the oral tablet represents an extension of that indication, officials said. The prescribing information now covers both the injectable and oral formulations, providing guidance on dosing, safety, and contraindications.

Regulatory authorities emphasized that the oral Wegovy tablet is currently approved only in the United States. The approval followed a separate authorization of Wegovy HD injection (7.2 mg) under the Critical to New Product Vitality (CNPV) program, which expedites review of innovative therapies addressing critical health priorities, according to FDA announcements. The CNPV program aims to facilitate faster access to treatments that improve affordability and patient outcomes.

Post-approval monitoring will continue to assess the safety profile of oral semaglutide, including reports of skin reactions that the FDA is investigating further. The agency also advises against combining oral Wegovy with other GLP-1 receptor agonists to minimize risks. As the medication becomes available, healthcare professionals will have an additional therapeutic option to support patients in achieving and maintaining weight loss, officials said.