GLP-1s impact on the Prosthetics industry

The panic emails started last year. GLP-1s are going to destroy the prosthetics industry.

I get it. The logic seems airtight: drugs like Ozempic and Wegovy prevent diabetes complications, diabetes causes most amputations; therefore, prosthetists are facing extinction. It's a neat equation that's been making the rounds at conferences and filling up industry forums with dread.

I've learned to be skeptical of neat equations in healthcare. They rarely account for messy reality.

Here’s my take on GLP-1s and what they mean for our field. It’s a lot less apocalyptic than you may think. 

What Are GLP-1s and Why Do They Matter?

First things first: Glucagon-like peptide-1 receptor agonists, medications like semaglutide (Ozempic, Wegovy), liraglutide (Victoza), and tirzepatide (Mounjaro), were originally developed to manage type 2 diabetes. They work by mimicking natural hormones that regulate blood glucose and appetite. The results have been remarkable: patients experience better glycemic control, significant weight loss (typically 10-15% BMI reduction over 6-12 months), and improved cardiovascular outcomes.

GLP-1s Impact on Amputations: What the Data Shows

A large-scale Danish cohort study tracking over 309,000 patients with type 2 diabetes found that those on GLP-1 treatment experienced a notable reduction in amputation risk compared to those without treatment. Similar findings emerged from U.S. studies, with one showing a 43% reduction in lower limb amputation risk. 

The mechanisms make sense: GLP-1s improve blood sugar control, enhance cardiovascular health and circulation, promote weight loss that reduces pressure on lower limbs, and appear to have anti-inflammatory and wound-healing properties.

But before we start planning exit strategies, let's look at what these numbers actually mean.

GLP-1s Won't Eliminate the Need for Prosthetics

Even with a 50% reduction in diabetes-related amputations, we're talking about cutting risk, not eliminating need. Diabetes accounts for 45-70% of lower extremity amputations, but it's far from the only cause. Trauma, cancer, congenital conditions, and vascular disease unrelated to diabetes continue to drive amputation rates regardless of GLP-1 adoption.

Moreover, the real-world adoption and adherence to GLP-1 therapy remain limited. Cost barriers, insurance coverage gaps, and side effects constrain their impact. Gastrointestinal issues alone lead to discontinuation rates around 17%, meaning nearly one in five patients stop treatment before seeing meaningful health benefits. Add to that the requirement for lifelong treatment, and many patients who do stop typically regain two-thirds of lost weight within a year.

The data shows prevention potential, not elimination of need. What's actually happening is a shift in the patient population we serve, not its disappearance.

GLP-1s Do Pose Interesting Fit Challenges

Here's what I find fascinating: GLP-1s may reduce some amputation risk, but they're creating an entirely new category of prosthetic fit challenges. The rapid weight loss characteristic of these medications, often 10-15% of body weight over months, creates unprecedented limb volume fluctuation scenarios.

Traditional prosthetic wisdom holds that just a 1% change in limb volume can alter socket fit enough to affect comfort and function. Prosthetists typically recommend a new socket when patients need to wear more than 10 ply worth of socks during the day. Now consider the challenge of managing a patient who experiences 15 to 30 kilograms of weight loss over six months while actively ambulating with their prosthesis.

The challenges are multifaceted. Residual limb volume decreases faster than traditional post-amputation maturation, requiring more frequent socket adjustments. Patients experience fit instability, rotation issues, and suspension problems as their limb shape changes. The muscle mass loss that accompanies GLP-1-driven weight reduction (up to 25-40% of total weight loss) affects load distribution and gait patterns.

Cassandra Delgado, a brilliant prosthetist whom I am lucky to call a friend, surveyed 152 colleagues in 2025 and found that three-quarters reported increases in socket adjustments, warranty remakes, or additional check sockets related to weight loss medications. She shared a story about one of her patients, a quadruple amputee who lost over 130 pounds on Wegovy and Zepbound. He's been going through two sockets a year for his legs. In December, he was fitted with a new socket with a 57-cm top opening to replace one with an 80-cm opening. When waiting on new sockets and literally able to walk out of the loose one, he fills the gap with five layers of socks. 

And there’s more: prosthetic feet are rated in four weight categories. When someone loses 130 pounds, they're literally in the wrong foot category. The foot becomes too rigid, doesn't compress properly, and causes rotation in the socket. These aren't minor annoyances; they're gait problems that increase fall risk, especially when you combine them with the muscle weakness that comes from rapid weight loss.

Then, there’s the insurance issue. 43% of prosthetists in the survey reported insurers requiring extended waiting periods for new sockets. Thirty-five percent struggled with getting medical necessity documented by physicians. Prosthetists are asking for a socket replacement during the warranty period because a patient lost 50 pounds in three months, and has to build a case for why that's not "cosmetic."

The Knowledge and Collaboration Gap

68% of prosthetists in Cassandra's survey had treated at least one patient on GLP-1s, yet just 4% said they had received education on the drugs. That’s a big knowledge gap! Only 8% collaborate regularly with endocrinologists, bariatric medicine specialists, and other members of the patient's general healthcare team. Most prosthetists are managing side effects of medications they don't understand, prescribed by doctors we rarely talk to.

Patients aren't always forthcoming either. Some patients are embarrassed to say that they are on it or think that it’s not information a prosthetist needs to know about. 

Most prosthetists are managing side effects of medications they don't understand, prescribed by doctors they rarely talk to, and, in some cases, are not aware the patient is taking.

What This Means for the Prosthetic Industry

Rather than shrinking our field, GLP-1s are demanding evolution. We need fit management workflows designed for rapid, ongoing volume change rather than the traditional stabilization model. We need tools and technologies that can accommodate frequent adjustments without requiring complete socket remakes every few months.

Solutions that address these exact challenges do exist. Technologies like the Kinn Automatic Volume Management System, which features automatic volume adjustment and allows both active and passive socket fit optimization, represent the kind of innovation this moment demands. When patients are experiencing consistent limb volume reduction from GLP-1 therapy, having a system that features automatic volume adjustment and allows both active and passive socket fit optimization becomes essential, not optional. The ability to manage fit fluctuations in real-time, without constant prosthetist intervention, addresses a genuine clinical need created by these medications.

Beyond technology, we should be investing in adjustable socket protocols, developing better volume management workflows, creating interdisciplinary care pathways with endocrinologists, and building patient education materials specifically for GLP-1 users with prosthetics.
The conversation shouldn't be about whether we'll have patients, but whether we're equipped to serve them through this new challenge.

The Bottom Line

GLP-1s are good news. Anything that reduces amputation risk is something we should celebrate. But the idea that these medications threaten the prosthetic industry fundamentally misunderstands both the data and the complexity of amputation care.

What GLP-1s are actually doing is highlighting gaps in our current prosthetic fitting paradigm, gaps that existed before but are now impossible to ignore. Patients have always experienced weight fluctuations, volume changes from health conditions, and fit issues requiring ongoing management. GLP-1s are simply accelerating and amplifying these challenges.

The prosthetic field that thrives in the coming decade won't be the one that fears medication advances. It will be the one that adapts to serve patients through them, with products and protocols designed for the reality of modern medical management.

That's the opportunity in front of us. Let's not miss it.

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~ By Sydney Robinson