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Ozempic and metformin are both popular weight loss drugs, but they work very differently, and only one is FDA approved to treat obesity.

Nevertheless, bone consequences of intentional weight loss interventions in PwO are well known: (i) significant weight loss induced by caloric restriction and bariatric surgery results in accelerated bone turnover and bone loss, and (ii) unlike caloric restriction interventions, PwO experience a substantial deterioration in bone microarchitecture and strength associated with an increased risk of fracture after bariatric surgery especially malabsorptive procedures

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Agents such as dulaglutide, liraglutide, semaglutide, and tirzepatide differ in pharmacology and dosing, directly influencing perioperative safety, particularly due to their effects on gastric motility and the high frequency of gastrointestinal (GI) adverse events that raise concerns about aspiration and postoperative morbidity in urgent or elective procedures