Body weight/composition and weight change: Effects on bone health

Abstract

A low body weight in older individuals is a major risk factor for fracture, and the maintenance of weight can prevent bone loss. Notwithstanding the above, newer information shows that obesity alters bone quality and is not always protective against osteoporosis and fracture, as previously thought. Weight reduction will have a different impact on bone, depending on the amount and whether it is involuntary or voluntary. Although mechanisms regulating bone loss are uncertain, it is clear that the method to achieve voluntary weight reduction (through different diets, medication, or increasing levels of activity) will determine the bone response. In addition, extreme weight loss due to bariatric surgery leads to bone loss and the long-term implications are discussed. Finally, alterations in bone quality and strength parameters due to weight reduction and regain suggest that bone lost is not recovered.