Effect of Weight Change Following Intentional Weight Loss on Bone Health in Older Adults with Obesity
Open accessAbstract
Objective: This study aimed to examine change in bone mineral density (BMD) and trabecular bone score among older adult weight regainers (WR) and weight maintainers (WM). Methods: Observational data come from 77 older adults (mean age: 67 [SD 5] years; 69% women; 70% white) with obesity (mean BMI: 33.6 [SD 3.7] kg/m 2) who lost weight during an 18‐month weight loss intervention. Total body mass and body composition, along with regional (total hip, femoral neck, lumbar spine) BMD and trabecular bone score, were measured at baseline, 18 months, and 30 months. WR (n = 36) and WM (n = 41) categories were defined as a ≥ 5% or < 5% weight gain from 18 to 30 months, respectively. Results: Among skeletal indices, only total hip BMD was significantly reduced during the 18‐month intervention period in both WRs (−3.9%; 95% CI: −5.8% to −2.0%) and WMs (−2.4%; 95% CI: −4.3% to −0.5%; P = 0.07). After adjustment for relevant baseline covariates and weight change from 0 to 18 months, 30‐month change in total hip BMD was −2.6% (95% CI: −4.3% to −0.9%) and −3.9% (95% CI: −5.7% to −2.1%) among WRs and WMs, respectively (P = 0.07). Conclusions: Loss of hip BMD persists in the year after a weight loss intervention among older adults with obesity, regardless of weight regain status.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some long-term data from lifestyle-based weight loss interventions suggest that lean mass and BMD may not be recovered with weight regain.
“As some long-term data from lifestyle-based weight loss interventions suggest LM (58) and BMD (59, 60) may not be recovered with weight regain, better understanding of the effects of intermittent use of GLP1Ra-based therapies on long-term change in body composition represents another important area of further inquiry.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The American Psychological Association
Langfeld, H. S. (1919) · Science · doi:10.1126/science.49.1254.51 · Cited by 7,453 · see citing works
Bone density at various sites for prediction of hip fractures
Cummings, S. R., Browner, W., Cummings, S. R., Black, D. M., Nevitt, M. C., Browner, W., Genant, H. K., Cauley, J., Ensrud, K., Scott, J., et al. (1993) · The Lancet · doi:10.1016/0140-6736(93)92555-8 · Cited by 2,446 · see citing works
Bone “mass” and the “mechanostat”: A proposal
Frost, H. M. (1987) · The Anatomical Record · doi:10.1002/ar.1092190104 · Cited by 2,132 · see citing works
CHAMPS Physical Activity Questionnaire for Older Adults: outcomes for interventions
Stewart, A. L., Mills, K. M., King, A. C., Haskell, W. L., Gillis, D., & Ritter, P. L. (2001) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200107000-00010 · Cited by 1,250 · see citing works
Osteoporosis and the Replacement of Cell Populations of the Marrow by Adipose Tissue
Meunier, P. J., Aaron, J., Edouard, C. M., & VlGNON, G. (1971) · Clinical Orthopaedics and Related Research · doi:10.1097/00003086-197110000-00021 · Cited by 779 · see citing works
Long-term weight loss maintenance in the United States
Kraschnewski, J. L., Boan, J., Esposito, J., Sherwood, N. E., Lehman, E. B., Kephart, D. K., & Sciamanna, C. N. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.94 · Cited by 381 · see citing works
Bone Metabolism in Obesity and Weight Loss
Shapses, S. A., & Sukumar, D. (2012) · Annual Review of Nutrition · doi:10.1146/annurev.nutr.012809.104655 · Cited by 347 · see citing works
Self-citationIntentional and Unintentional Weight Loss Increase Bone Loss and Hip Fracture Risk in Older Women
Ensrud, K. E., Ewing, S. K., Stone, K. L., Cauley, J. A., Bowman, P. J., Cummings, S. R., & for the Study of Osteoporotic Fractures Research Group (2003) · Journal of the American Geriatrics Society · doi:10.1046/j.1532-5415.2003.51558.x · Cited by 336 · see citing works
Silva, B. C. C., Broy, S. B., Boutroy, S., Schousboe, J. T., Shepherd, J., & Leslie, W. D. (2015) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2015.06.008 · Cited by 330 · see citing works
Obesity and fractures in postmenopausal women
Premaor, M. O., Pilbrow, L., Tonkin, C., Parker, R. A., & Compston, J. E. (2009) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.091004 · Cited by 304 · see citing works
Obesity and fracture in men and women: an epidemiologic perspective
Nielson, C. M., Srikanth, P., & Orwoll, E. S. (2012) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.1486 · Cited by 253 · see citing works
Westerlind, K. C., Wronski, T. J., Ritman, E. L., Luo, Z.-P., An, K., Bell, N. H., & Turner, R. T. (1997) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.94.8.4199 · Cited by 207 · see citing works
Influence of body weight on bone mass, architecture and turnover
Iwaniec, U. T., & Turner, R. T. (2016) · Journal of Endocrinology · doi:10.1530/joe-16-0089 · Cited by 199 · see citing works
BMI and BMD: the potential interplay between obesity and bone fragility
Palermo, A., Tuccinardi, D., Defeudis, G., Watanabe, M., D’Onofrio, L., Lauria Pantano, A., Napoli, N., Pozzilli, P., & Manfrini, S. (2016) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph13060544 · Cited by 197 · see citing works
Determinants of Bone Loss in Elderly Men and Women: A Prospective Population-Based Study
Dennison, E. M., Eastell, R., Fall, C. H. D., Kellingray, S., Wood, P. J., & Cooper, C. C. (1999) · Osteoporosis International · doi:10.1007/s001980050244 · Cited by 183 · see citing works
Obesity is a concern for bone health with aging
Shapses, S. A., Pop, L. C., & Wang, Y. (2017) · Nutrition Research · doi:10.1016/j.nutres.2016.12.010 · Cited by 179 · see citing works
Self-citationZibellini, J., Seimon, R. V., Lee, C. M., Gibson, A. A., Hsu, M. S., Shapses, S. A., Nguyen, T. V., & Sainsbury, A. (2015) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.2564 · Cited by 157 · see citing works
Self-citationEnsrud, K. E., Fullman, R. L., Barrett-Connor, E. L., Cauley, J. A., Stefanick, M. L., Fink, H. A., Lewis, C. E., & ORWOLL, E. S. (2005) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1805 · Cited by 155 · see citing works
Weight variability and incident disease in older women: the Iowa Women's Health Study
French, S. A., Folsom, A., Jeffery, R. W., Zheng, W., Mink, P., & Baxter, J. (1997) · International Journal of Obesity · doi:10.1038/sj.ijo.0800390 · Cited by 137 · see citing works
Fogelholm, M., nen, H. S., Kukkonen-Harjula, T. K., & Pasanen, M. E. (2001) · Osteoporosis International · doi:10.1007/s001980170130 · Cited by 121 · see citing works
Johnson, K. C., Bray, G. A., Cheskin, L. J., Clark, J. M., Egan, C. M., Foreyt, J. P., Garcia, K. R., Glasser, S., Greenway, F. L., Gregg, E. W., et al. (2017) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3214 · Cited by 104 · see citing works
Obesity and fractures in postmenopausal women
Compston, J. E. (2015) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000182 · Cited by 92 · see citing works
Body mass index (BMI) and parameters of bone formation and resorption in postmenopausal women
Papakitsou, E., Margioris, A. N., Dretakis, K., Trovas, G., Zoras, U., Lyritis, G. P., Dretakis, E. K., & Stergiopoulos, K. (2003) · Maturitas · doi:10.1016/s0378-5122(03)00282-2 · Cited by 89 · see citing works
Meyer, H. E., Tverdal, A., & Selmer, R. M. (1998) · Osteoporosis International · doi:10.1007/s001980050077 · Cited by 88 · see citing works
Beavers, K. M., Ambrosius, W. T., Rejeski, W. J., Burdette, J. H., Walkup, M. P., Sheedy, J. L., Nesbit, B. A., Gaukstern, J. E., Nicklas, B. J., & Marsh, A. P. (2017) · Obesity · doi:10.1002/oby.21977 · Cited by 88 · see citing works
Self-citationBone loss associated with a high fibre weight reduction diet in postmenopausal women.
Avenell, A., Richmond, P., Lean, M. E. J., & Reid, D. M. (1994) · PubMed · Cited by 87 · see citing works
Beavers, K. M., Walkup, M. P., Weaver, A. A., Lenchik, L., Kritchevsky, S. B., Nicklas, B. J., Ambrosius, W. T., Stitzel, J. D., Register, T. C., Shapses, S. A., et al. (2018) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3555 · Cited by 69 · see citing works
Self-citationVillalon, K. L., Gozansky, W. S., van Pelt, R. E., Wolfe, P., Jankowski, C. M., Schwartz, R. S., & Kohrt, W. M. (2011) · Obesity · doi:10.1038/oby.2011.263 · Cited by 67 · cited 3× · see citing works
“Observational data indicate that weight variability and regain can contribute to increased risk of fracture (19-21), and emerging data suggest that BMD is not recovered by weight regain and that bone loss can continue to occur after weight loss ends (22-24).”
BackgroundKim, Y., Han, J., Lee, J., Choi, H. S., Kim, J. H., & Lee, T. (2017) · Osteoporosis and Sarcopenia · doi:10.1016/j.afos.2017.02.001 · Cited by 64 · see citing works
Community Weight Loss to Combat Obesity and Disability in At-Risk Older Adults
Rejeski, W. J., Ambrosius, W. T., Burdette, J. H., Walkup, M. P., & Marsh, A. P. (2017) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glw252 · Cited by 58 · see citing works
Self-citationCalorie restriction in overweight older adults: Do benefits exceed potential risks?
Locher, J. L., Goldsby, T. U., Goss, A. M., Kilgore, M. L., Gower, B. A., & Ard, J. D. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.03.009 · Cited by 57 · see citing works
Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults
Waters, D. L., Vawter, R., Qualls, C., Chode, S., Armamento-Villareal, R., & Villareal, D. T. (2013) · The Journal of nutrition, health and aging · doi:10.1007/s12603-012-0421-5 · Cited by 51 · see citing works
Obesity: Friend or foe for osteoporosis
Sharma, S., Tandon, V., Mahajan, S., Mahajan, V., & Mahajan, A. (2014) · Journal of Mid-life Health · doi:10.4103/0976-7800.127782 · Cited by 51 · see citing works
Association between weight cycling history and bone mineral density in premenopausal women
Fogelholm, M., Sievänen, H. T., Heinonen, A. O., Virtanen, M. A., Uusi‐Rasi, K., Pasanen, M. E., & VUORI, I. M. (1997) · Osteoporosis International · doi:10.1007/bf01623777 · Cited by 49 · see citing works
Bosy‐Westphal, A., Later, W., Schautz, B., Lagerpusch, M., Goele, K., Heller, M., Glüer, C., & Müller, M. J. (2011) · Obesity · doi:10.1038/oby.2011.40 · Cited by 47 · see citing works
Thun, N. L. V., Sukumar, D., Heymsfield, S. B., & Shapses, S. A. (2013) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e3182a76fd5 · Cited by 46 · see citing works
Self-citationHinton, P. S., Rector, R. S., Linden, M. A., Warner, S. O., Dellsperger, K. C., Chockalingam, A., Whaley‐Connell, A. T., Liu, Y., & Thomas, T. R. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.212 · Cited by 42 · see citing works
Stolzenberg‐Solomon, R. Z., Falk, R. T., Stanczyk, F. Z., Hoover, R. N., Appel, L. J., Ard, J. D., Batch, B. C., Coughlin, J. W., Han, X., Lien, L. F., et al. (2012) · Breast Cancer Research · doi:10.1186/bcr3346 · Cited by 32 · see citing works
The Cooperative Lifestyle Intervention Program-II (CLIP-II): Design and methods
Marsh, A. P., Janssen, J. A., Ambrosius, W. T., Burdette, J. H., Gaukstern, J. E., Morgan, A. R., Nesbit, B. A., Paolini, J. B., Sheedy, J. L., & Rejeski, W. J. (2013) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.08.006 · Cited by 29 · see citing works
Self-citationWeight Cycling and Risk of Forearm Fractures: A 28-Year Follow-up of Men in the Oslo Study
Søgaard, A. J., Meyer, H. E., Tonstad, S., Håheim, L. L., & Holme, I. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwm384 · Cited by 28 · see citing works
Lurati, A., & Laria, A. (2015) · Rheumatology Current Research · doi:10.4172/2161-1149.1000181 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Malandrino, N., Bhat, S. Z., Alfaraidhy, M., Grewal, R. S., & Kalyani, R. R. (2023) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2022.10.001 · Cited by 61 · see citing works
Mesinovic, J., Jansons, P., Zengin, A., de Courten, B. V., Rodríguez, A. J., Daly, R. M., Ebeling, P. R., & Scott, D. S. (2021) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2021.05.001 · Cited by 53 · see citing works
Beavers, K. M., Cortes, T. M., Foy, C. M., Dinkla, L., Reyes San Martin, F., Ard, J. D., Serra, M. C., & Beavers, D. P. (2025) · Obesity · doi:10.1002/oby.24172 · Cited by 41 · see citing works
Self-citationDietary weight-loss interventions for the management of obesity in older adults
Goisser, S., Kiesswetter, E., Schoene, D., Torbahn, G., & Bauer, J. M. (2020) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-020-09577-2 · Cited by 33 · see citing works
Seimon, R. V., Wild-Taylor, A. L., McClintock, S., Harper, C., Gibson, A. A., Johnson, N. A., Fernando, H. A., Markovic, T. P., Center, J. R., Franklin, J., et al. (2020) · Heliyon · doi:10.1016/j.heliyon.2020.e04007 · Cited by 30 · see citing works
Leslie, W. D., Schousboe, J. T., Morin, S. N., Martineau, P., Lix, L. M., Johansson, H., McCloskey, E. V., Harvey, N. C., & Kanis, J. A. (2020) · Archives of Osteoporosis · doi:10.1007/s11657-020-00773-w · Cited by 27 · see citing works
CORTES, T. M., Chae, K., Foy, C. M., Houston, D. K., & Beavers, K. M. (2025) · Obesity · doi:10.1002/oby.24229 · Cited by 26 · see citing works
Self-citationThe Impact of Exercise on Bone Health in Type 2 Diabetes Mellitus—a Systematic Review
Viggers, R., Al-Mashhadi, Z. K., Fuglsang-Nielsen, R., Gregersen, S., & Starup‐Linde, J. (2020) · Current Osteoporosis Reports · doi:10.1007/s11914-020-00597-0 · Cited by 18 · see citing works
Bone Mineral Density Changes during Weight Regain following Weight Loss with and without Exercise
Serra, M. C., & Ryan, A. S. (2021) · Nutrients · doi:10.3390/nu13082848 · Cited by 17 · see citing works
Wherry, S. J., Miller, R. M., Jeong, S. H., & Beavers, K. M. (2021) · Nutrients · doi:10.3390/nu13041250 · Cited by 16 · see citing works
Self-citationLegrand, M. A., Paccou, J., Lecerf, J., Thomas, T., Chapurlat, R. D., Cortet, B., Biver, E., & Papageorgiou, M. (2025) · Obesity · doi:10.1002/oby.70047 · Cited by 8 · see citing works
Amariti, J., McGuire, B. D., Ogilvie, A. R., Beavers, K. M., Hansen, K. E., Schlussel, Y., Walkup, M. P., & Shapses, S. A. (2022) · Calcified Tissue International · doi:10.1007/s00223-022-00973-1 · Cited by 7 · see citing works
Self-citationChoi, H. G., Kwon, B. C., Yim, S.-H., Youk, H., & Lee, J. W. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413368 · Cited by 6 · see citing works
Cancello, R., Vigna, L., Maggio, A. D., Capodaglio, P., Bertoli, S., & Brunani, A. (2024) · Minerva Endocrinology · doi:10.23736/s2724-6507.24.04077-6 · Cited by 6 · see citing works
Chen, Q., Liu, D., Li, X., Li, F., Guo, S., Wang, S., Yuan, W., Chen, P., Pan, L., Li, F., et al. (2024) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-024-08239-7 · Cited by 5 · see citing works
Haxhi, J., Mattia, L., Vitale, M., Pisarro, M., Conti, F., & Pugliese, G. (2022) · International Journal of Bone Fragility · doi:10.57582/ijbf.220201.020 · Cited by 4 · see citing works
Wang, J., Wang, Y., Zheng, Y., Li, Y., Fan, M., Tian, W., Jiang, Y., Wang, Y., Cui, M., Suo, C., et al. (2024) · Preventive Medicine · doi:10.1016/j.ypmed.2024.107999 · Cited by 3 · see citing works
How do you treat obesity in the elderly pharmacologically?
González, C. D., & Girolamo, G. D. (2021) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2021.1921150 · Cited by 3 · see citing works
Song, G., Li, M., Bao, X., Wu, G., Liu, M., Zhang, W., Li, Y., & Wang, Y. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1642801 · Cited by 2 · see citing works
Clinical consequences of the sarcopenic obesity. Part 2. Cardiovascular diseases and osteoporosis
Sheptulina, A. F., Bryk, D. D., Тамерланович, Ц. Т., Yafarova, A. A., Mamutova, E. M., & Drapkina, O. M. (2024) · Russian Journal of Preventive Medicine · doi:10.17116/profmed20242709160 · Cited by 2 · see citing works
Mao, W., & Wu, L. (2025) · Journal of Pain Research · doi:10.2147/jpr.s516682 · Cited by 1 · see citing works
Perspective Chapter: Beyond BMI – Rethinking Obesity Assessment in Women’s Health
GÜRBÜZ, T., & Gökmen, O. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1012799 · Cited by 1 · see citing works
Arenas-Sánchez, G., Cortés, L. J., Arce, M. A., Villacura, L. E. P., & Salinas, A. E. (2021) · Revista de Nutrición Clínica y Metabolismo · doi:10.35454/rncm.v4n3.292 · Cited by 2 · see citing works
How to Help My Older Patient With Obesity Lose Weight Safely When the Evidence Is Not Clear
Nowicki, K. N., Daugherty, J. E., Craven, K., & Kolasa, K. M. (2022) · Nutrition Today · doi:10.1097/nt.0000000000000568 · Cited by 1 · see citing works
Bone Mineral Density in a Shanghai Population Aged 40–60 YearsPreprint
陈, 倩., Liu, D., Li, X., Li, F., Guo, S., Wang, S., Yuan, W., Chen, P., Pan, L., Li, F., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-4231579/v1
Ageing and Mid-Life Adult Considerations
Deaton, C. (2024) · Springer eBooks · doi:10.1007/978-3-031-53705-9_23
He, J. H., Bennett, W. L., Ma, J., Oyeka, C. P., Kodali, L. S., Srialluri, N., Gisinger, T., Woodward, M., Michos, E. D., Johnson, K., et al. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf359
Xie, J., & Luo, S. (2026) · Microchemical Journal · doi:10.1016/j.microc.2026.117961
Why Do We Lose Bone During Weight Loss: Can It Be Prevented?
Shapses, S. A., & McGuire, B. D. (2026) · Current Osteoporosis Reports · doi:10.1007/s11914-026-00984-z
Self-citation
- Authors
- Kammire, D. E., Walkup, M. P., Ambrosius, W. T., Lenchik, L., Shapses, S. A., Nicklas, B. J., Houston, D. K., Marsh, A. P., Rejeski, W. J., & Beavers, K. M.
- Affiliations
- Wake Forest University (US)
- Wake Forest University Health Sciences (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Beavers, Kristen M.
- ORCID
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2019-09-04
- Volume
- 27
- Issue
- 11
- Pages
- 1839-1845
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC6832808
- OpenAlex
- W2971568853
- Cited by
- 31
- References
- 41
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 4
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- WakeSpace Scholarship (Wake Forest University) (submittedVersion)
- WakeSpace (Wake Forest University) (submittedVersion)
- Funders
- National Institute on Aging (K01 AG047921)
- National Heart, Lung, and Blood Institute (R18 HL076441)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- weight regain, intentional weight loss, bone mineral density, trabecular bone score, older adults, hip bone loss, weight loss interventions, bone health, body composition
- MeSH terms
- Aged, Aging, Body Composition, Body Weight, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Osteoporosis, Weight Gain, Weight Loss, Bone Density, Weight Reduction Programs
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
