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In a recent randomized trial, one year of combined GLP-1 therapy with exercise training preserved bone mineral density, while GLP-1 therapy alone decreased bone mineral density [162]

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However, the TMD binding cavity is even more open in the presence of exendin-P5, due to a more outward location of TM7

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8 Reasons for less weight loss with GLP1 RAs for T2D could include use of insulin or other obesity-promoting medications, concerns over hypoglycemia, decreased glycosuria, microbiome variation, genetic predisposition towards weight gain, and differences in endogenous GLP-1 pathways in the brain and other tissues

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