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• The negative health effects of ultra-processed foods are of increasing interest to researchers.
• A new study has found that eating more ultra-processed foods may worsen muscle health.
• Another recent study has shown that eating more ultra-processed foods may be associated with weaker bones.
• Recent research has also found that eating higher amounts of ultra-processed foods may affect fertility in females.
• Common health risks linked to ultra-processed food intake include obesity, cardiovascular disease, type 2 diabetes, and premature death.

The impacts of ultra-processed food consumption on human health are a growing concern.

A review from February found that ultra-processed foods may be as addictive as tobacco products. The researchers noted that the way these foods can rapidly deliver “feel-good” chemicals to the brain can make them potentially addictive. These addictive qualities can make people want to eat more of them.

While these health effects have been widely established, other studies are examining the lesser-known health impacts. These include poorer muscle and bone health, as well as fertility issues in females. Here’s what you need to know.

Higher amounts of intramuscular fat in the thigh may increase a person’s risk of knee osteoarthritis.

“Over the past decades, in parallel to the rising prevalences of obesity and knee osteoarthritis, the use of natural ingredients in our diets has steadily diminished and been replaced by industrially-processed, artificially flavored, colored and chemically altered food and beverages, which are classified as ultra-processed foods,” said lead study author Zehra Akkaya, MD, researcher and consultant for the Clinical & Translational Musculoskeletal Imaging group at University of California, San Francisco, in a press release.

The research team found that people who consumed more ultra-processed foods showed increased intramuscular fat storage, regardless of their caloric intake.

Along with other health benefits, reducing your intake of ultra-processed foods may help preserve muscle quality and alleviate the burden of knee osteoarthritis.

A study published in March found that people who eat more ultra-processed foods had a higher risk of hip fractures and lower bone mineral density.

The findings were pronounced in adults of all ages, including younger adults under 65, as well as those who were underweight.

“Our study cohort was followed for over 12 years, and we found that high intakes of ultra-processed foods were linked to a reduction in bone mineral density at several sites including key areas of the upper femur and the lumbar spine region,” said Lu Qi, MD, PhD, co-author of the study and HCA Regents Distinguished Chair and professor at the Celia Scott Weatherhead School of Public Health and Tropical Medicine at Tulane University, in a press release.

The researchers analyzed data from 160,000 participants from the UK Biobank. Individuals typically ate around 8 servings of ultra-processed foods per day.

They found that for every 3.7 additional servings of ultra-processed foods, the risk of hip fracture increased by 10.5%.

“A 10.5% increase in hip fracture risk is meaningful, especially given how serious hip fractures can be for long-term mobility and independence, particularly in older adults,” Grace Derocha, a registered dietitian nutritionist and national spokesperson for the Academy of Nutrition and Dietetics, told Healthline in an earlier interview.

“That said, it is important to interpret this in context. This is an observational finding, meaning it shows an association rather than direct causation,” she continued.

Derocha added that this still reinforces the pattern seen across nutrition science: diets higher in ultra-processed foods tend to be linked to poorer overall health outcomes.

“From a public health standpoint, it’s a signal worth paying attention to — not necessarily a reason for alarm, but certainly a reason to emphasize improving overall diet quality,” she said.

A recent study published in Nutrition and Health found that females who ate fewer ultra-processed foods may be more likely to have higher fertility.

This link seemed to persist even after the researchers accounted for factors such as age, weight, and lifestyle.

The study analyzed data from 2,582 females who participated in the National Health and Nutrition Examination Survey (NHANES). NHANES is a United States survey that combines interviews, 24-hour dietary recalls, and laboratory tests to capture details about diet, demographics, health status, and biomarkers.

The research team found clear differences in the diet of females who reported issues with infertility and those who didn’t. Infertility was defined as “the inability to conceive after 12 months of regular unprotected intercourse.”

The females who reported issues with infertility consumed more ultra-processed foods, making up about 31% their daily food intake. They also scored lower on adherence to a Mediterranean diet, a healthy eating pattern rich in fruits, vegetables, whole grains, and healthy fats.

“Most of what we hear about ultra-processed foods focuses on calories and obesity. But our findings suggest something potentially more complex — there seems to be another mechanism at play which may reflect pathways beyond calories or weight, including chemical exposures that have been hypothesized in prior literature,” said Anthea Christoforou, PhD, assistant professor of kinesiology at McMaster University, and senior author of the study, in a press release.

She added that even if a person’s nutrient intake appears fine, eating more ultra-processed foods means greater exposure to additives and chemicals beyond calories.

The Mediterranean diet showed a positive association with fertility. However, the benefit seemed to disappear after factoring in obesity. This means the diet’s effect may come from helping females maintain a healthy weight and metabolism.

The study’s findings may appear modest at the individual level. But in fully adjusted models, a higher intake of ultra-processed foods was associated with around 60% lower odds of fertility.

It is important to remember that the findings reflect an association rather than a causal relationship. However, an association of this size could have meaningful implications at the population level, particularly given the widespread consumption of ultra-processed foods.

“It suggests diet may be an important and measurable factor associated with women’s ability to conceive. It’s one thing to say ultra-processed foods contribute to weight gain or cardiometabolic disease. But if they’re also affecting hormone pathways, that’s a much bigger issue — and it’s something people aren’t as aware of,” said Christoforou in the press release.

There are some well-established risks associated with ultra-processed food consumption.

A 2025 review showed that ultra-processed foods are likely contributing to the obesity epidemic. The researchers reported that there is evidence that ultra-processed foods promote overeating, increasing the risk of obesity.

“This confirms what we know that ultra-processed foods are a detriment to the body,” said Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, in a previous interview with Healthline.

“These findings indicate that ultra-processed food consumption increases the risk for prediabetes and type 2 diabetes among young adults — and that limiting consumption of those foods can help prevent disease,” said Yiping Li, one of the study authors and a doctoral researcher in quantitative biomedical sciences at Dartmouth College, in a press release.

A study recently published in JACC Journals found that eating more ultra-processed foods can increase the risk of atherosclerotic cardiovascular disease (ASCVD). The study showed that those who consume more than 9 servings of ultra-processed foods per day have a 67% higher risk of major cardiac events than those who consume only 1 serving.

The researchers also found that this risk increases with each additional serving of ultra-processed foods. Each additional daily serving was associated with a more than 5% increased risk of heart attack, stroke, or death from one of these events.

“Ultra-processed foods are associated with an increased risk for heart disease, and while many of these products may seem like convenient on-the-go meal or snack options, our findings suggest they should be consumed in moderation,” Amier Haidar, MD, a cardiology fellow at the University of Texas Health Science Center at Houston and the study’s lead author, said in a press release.

• GLP-1 medications may not always be effective for everyone.
• New research suggests that around 10% of people carry genetic variations that explain why.
• A new review suggests that certain combination approaches for obesity pharmacotherapy may be effective when GLP-1 drugs are not.
• Experts share recommendations for alternative weight loss strategies.

GLP-1 medications have exploded in popularity to manage type 2 diabetes and treat obesity.

The popularity of this class of medications, which includes Ozempic and Wegovy, is partly due to their widespread success for weight loss.

However, new research published in Genome Medicine shows that GLP-1 drugs may not be effective for everyone. The findings suggest that certain genetic factors may offer an explanation.

Around 10% of people carry genetic variations linked to “GLP-1 resistance.” These individuals appear to have higher-than-normal levels of the hormone glucagon-like peptide-1 (GLP-1). GLP-1 helps to regulate blood sugar. In contrast, the hormone appears less effective despite higher GLP-1 levels.

“This aligns with my clinical experience, where I frequently see a variable response to GLP-1 medications,” said Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. Ali wasn’t involved in the study.

It’s unclear whether these genetic variations influence weight loss. GLP-1 drugs are generally prescribed at higher doses for weight loss than for diabetes management. The current study focused on how GLP-1s and these genetic variants influence blood sugar levels.

The study focused on two genetic variants that affect the enzyme peptidyl-glycine alpha-amidating monooxygenase (PAM).

PAM plays a role in activating various hormones, including GLP-1.

Certain variants of PAM are more common in those with diabetes and may impair the release of insulin from the pancreas. The research team sought to determine whether these variants also disrupt GLP-1.

In addition to helping regulate blood sugar, GLP-1 also stimulates insulin release after meals, slows stomach emptying, and reduces appetite. GLP-1 drugs are made to mimic the effects of this hormone.

When the research team analyzed individuals with a PAM variant called p.S539W, they expected to find lower GLP-1 levels. However, they found elevated levels of GLP-1 in these individuals.

They also found that, even with higher GLP-1 levels, participants did not reduce their blood sugar levels more quickly. More GLP-1 was needed to achieve the same biological effect, indicating the participants were GLP-1-resistant.

“These findings support the idea that some patients may have partial biologic resistance to incretin-based therapies,” said Robert Glatter, MD, attending physician in the Department of Emergency Medicine at Lenox Hill Hospital in New York City, and Assistant Professor of Emergency Medicine at Zucker School of Medicine at Hofstra/ Northwell. Glatter wasn’t involved in the study.

“Still, genetics explains only a portion of treatment heterogeneity, and routine pharmacogenomic screening is not yet ready for widespread clinical use,” he added.

More research is needed to verify the effects genetic variations can have on weight loss with GLP-1s. Still, the findings show promise for the future of obesity treatment.

“The broader lesson from recent research is that obesity treatment is entering a precision-medicine era,” Glatter said. “Instead of asking whether GLP-1 medications work, clinicians are beginning to ask for whom they work best — and what alternative pathways should be considered when responses are incomplete.”

We asked our experts to explain why GLP-1s don’t always work for weight loss and what alternatives are available. These interviews have been lightly edited for clarity.

Ali: Other factors can include underlying medical conditions or the patient not using the medications exactly as prescribed.

Glatter: In practice, many patients labeled “non-responders” to GLP-1 therapy are experiencing incomplete dosing, early discontinuation because of gastrointestinal side effects, insufficient treatment duration, or competing metabolic drivers such as severe insulin resistance, sleep disruption, sarcopenia, or medication-associated weight gain.

Addressing these contributors often restores treatment effectiveness.

Ali: If a patient meets the criteria, surgical weight loss remains the most effective long-term solution.

Glatter: Another important option that deserves earlier consideration—not later referral—is metabolic and bariatric surgery. Too often framed as a last resort after medication failure, surgery is better understood as a parallel therapeutic strategy within the same treatment continuum.

Procedures such as sleeve gastrectomy and Roux-en-Y gastric bypass produce average weight reductions of 25 to 35% and remain the most durable interventions available for severe obesity and obesity-related metabolic disease.

Importantly, surgery also alters incretin signaling itself, increasing GLP-1 activity and improving insulin sensitivity in ways that complement pharmacologic therapies.

Glatter: When response remains limited despite optimization, clinicians should consider moving beyond monotherapy.

Obesity is a network disease involving appetite regulation, reward signaling, gut-brain hormones, and energy expenditure pathways.

Combination pharmacotherapy — such as pairing incretin agents with phentermine, topiramate, or bupropion-naltrexone — targets complementary mechanisms and is increasingly supported by mechanistic and clinical evidence. Rather than representing treatment escalation alone, combination therapy reflects a broader shift toward multimodal metabolic care.

Ali: If surgery is not an option, we can try medications that stimulate more than one receptor (such as Zepbound) or a combination of different medications.

Ali: The majority of weight loss is driven by dietary modifications—primarily reducing carbohydrate and sugar intake while emphasizing proteins and vegetables. Adding both aerobic and resistance exercise further helps burn calories and mitigate muscle loss.

Glatter: Additional approaches to lose weight and manage cardiometabolic aspects of obesity include adherence to the Mediterranean, DASH, or MIND diet, along with adequate strength training, close monitoring of hydration status, and caloric intake to maintain and prevent muscle loss, particularly while taking a GLP-1.

Even if one chooses not to take a GLP-1 to manage weight loss, adherence to a Mediterranean-style diet, adequate hydration, and resistance training combined with aerobic exercise is recommended for weight loss and preservation of muscle mass.