Does Bone Loss Begin After Weight Loss Ends?
This study shows that weight reduction-induced bone loss that is apparent immediately after weight loss either continues or first begins at the trochanter, femoral neck, and radius in postmenopausal women. Weight regain does not result in recovery of bone, but it prevents greater loss at the trochanter and 1/3 radius compared with reduced-obese women. Even after weight loss, about 50% of women in the WL-M group were still overweight. Thus, weight loss would be recommended for these individuals, who typically would not be considered at risk for osteoporosis based on their overweight status. There is concern that repeated dieting would enhance bone loss and osteoporosis risk in this population compared with obese women who have been weight-stable, possibly owing to poor bone quality, but specific studies have not been conducted.
Hence, questions about weight history should be considered when evaluating risk of osteoporosis. Current recommendations appropriately encourage weight loss in overweight individuals to reduce the risk of comorbidities. Until future prospective studies have addressed how to prevent bone loss after a successful weight reduction, therapies that have been shown toa meliorate bone loss during weight reduction—such as adequate calcium and vitamin D, higher protein intake, and increased bone-loading exercise—should also be encouraged after weight stabilizes. Whether BMD changes in cortical or trabecular bone affect geometry after weight loss remains an important question in the prevention of fracture risk.
Conclusions
This study shows that weight reduction-induced bone loss that is apparent immediately after weight loss either continues or first begins at the trochanter, femoral neck, and radius in postmenopausal women. Weight regain does not result in recovery of bone, but it prevents greater loss at the trochanter and 1/3 radius compared with reduced-obese women. Even after weight loss, about 50% of women in the WL-M group were still overweight. Thus, weight loss would be recommended for these individuals, who typically would not be considered at risk for osteoporosis based on their overweight status. There is concern that repeated dieting would enhance bone loss and osteoporosis risk in this population compared with obese women who have been weight-stable, possibly owing to poor bone quality, but specific studies have not been conducted.
Hence, questions about weight history should be considered when evaluating risk of osteoporosis. Current recommendations appropriately encourage weight loss in overweight individuals to reduce the risk of comorbidities. Until future prospective studies have addressed how to prevent bone loss after a successful weight reduction, therapies that have been shown toa meliorate bone loss during weight reduction—such as adequate calcium and vitamin D, higher protein intake, and increased bone-loading exercise—should also be encouraged after weight stabilizes. Whether BMD changes in cortical or trabecular bone affect geometry after weight loss remains an important question in the prevention of fracture risk.
Source...