Weight loss-induced reduction of bone mineral density in older adults with obesity
Open accessAbstract
Obesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m2 and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases total hip bone mineral density and increases the risk of frailty fractures (composite of proximal femur, pelvis, and proximal humerus fractures). Randomized controlled trials have largely confirmed these earlier observations but have also shown that exercise, particularly progressive resistance training, can attenuate or even alleviate this bone loss. Further research incorporating outcomes concerning bone quality and mass are needed to identify the optimal exercise and nutritional regimens to counteract the bone loss.
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Calorie restriction-induced weight loss causes a decline in lean mass and bone mineral density.
“Weight loss achieved through calorie restriction causes a decline in lean mass and bone mineral density.”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [10]
The section “Effect of Weight Loss on Bone Mass and Fracture Risk in Older Adults” reports that diet-only weight loss reduced total-hip BMD in older adults with obesity. “Mechanisms for Bone Loss” discusses muscle loss during voluntary weight loss, and “Measures to Counter Bone Loss” says higher-protein diets help preserve lean mass during weight-loss interventions. The citing sentence omits the paper’s focus on older adults with obesity and states the effects as a general consequence of calorie restriction. (LLM, conf=0.84)
Experimental — accuracy not yet measuredProgressive resistance training during calorie restriction reduces bone mineral density loss.
“When performed alongside CR, progressive resistance training (RT) attenuates this loss of lean mass and bone mass, while the addition of aerobic training (AT) further improves cardiorespiratory fitness.”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [10]
Weight loss interventions are associated with loss of lean body mass and bone mineral density.
“concerns persist about the loss of lean body mass and bone mineral density (BMD) associated with weight loss interventions (9,10).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [10]
Preservation of skeletal muscle by resistance training during calorie restriction mitigates loss of total hip bone mineral density assessed with DXA.
“the preservation of skeletal muscle by RT during CR mitigates the loss of BMD at the total hip, assessed with DXA (10).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [10]
Potential negative effects of hypocaloric diets on micronutrient status and bone mineral density may occur.
“Potential negative effects on micronutrient status and on bone mineral density may also occur166.”
From Sarcopenic obesity in older adults: a clinical overview (2024) · cites this paper as [166]
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- Authors
- Jiang, B. C., & Villareal, D. T.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- Corresponding author
- Villareal, Dennis T.
- ORCID
- Villareal, Dennis T.
- Venue
- Journal of Nutrition in Gerontology and Geriatrics
- Publisher
- Informa UK Limited
- Published
- 2019-01-02
- Volume
- 38
- Issue
- 1
- Pages
- 100-114
- ISSN
- 2155-1197 (ISSN-L)
- 2155-1200
- PMC
- PMC6480356
- OpenAlex
- W2916715307
- Cited by
- 50
- References
- 69
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 9 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 3
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Nutrition in Gerontology and Geriatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Michael E. DeBakey VA Medical Center
- 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 loss, bone mineral density, obesity, older adults, hip bone loss, fracture risk, resistance training, physical activity, bone health, dietary intervention
- MeSH terms
- Aged, Diet, Reducing, Humans, Obesity, Weight Loss, Exercise, Bone Density, Body Mass Index, Frail Elderly, Fractures, Bone
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