Bone, Body Weight, and Weight Reduction: What Are the Concerns?
Open accessAbstract
Of the U.S. population, 65% is either overweight or obese, and weight loss is recommended to reduce co-morbid conditions. However, bone mobilization and loss may also occur with weight loss. The risk for bone loss depends on initial body weight, age, gender, physical activity, and conditions of dieting such as the extent of energy restriction and specific levels of nutrient intake. Older populations are more prone to bone loss with weight loss; in women, this is due at least in part to a reduced dietary Ca intake and/or efficiency of absorption. Potential hormonal mechanisms regulating bone loss during weight loss are discussed, including decreases in estrogen, leptin, glucagon-like peptide-2, growth hormone, and insulin-like growth factor-1, or an increase in cortisol. In contrast, the rise in adiponectin and ghrelin with weight reduction should not be detrimental to bone. Combining energy restriction with exercise does not necessarily prevent bone loss, but may attenuate loss as was shown with additional Ca intake or osteoporosis medications. Future controlled weight loss trials should be designed to further address mechanisms influencing the density and quality of bone sites vulnerable to fracture, in the prevention of osteoporosis.
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Bone loss during weight reduction is influenced by initial body weight, age, sex, physical activity, extent of energy restriction and protein intake, and rate of weight reduction, with older individuals and females experiencing greater bone loss.
“Bone loss is influenced by initial body weight, age, sex, physical activity, extent of energy restriction and protein intake, and rate of weight reduction, with older individuals and females experiencing greater bone loss [71].”
From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [71]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredWeight reduction that is substantial (at least 14%) and rapid (over 3-4 months) is associated with significant bone loss, whereas more moderate and slower weight reduction may better preserve bone mass.
“Weight reduction that is substantial (≥14%) and rapid (over 3–4 months) is associated with significant bone loss [71], whereas more moderate and slower weight reduction may better preserve bone mass [72].”
From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [71]
The “Weight reduction and bone” section (page not specified) says that ≥14% weight loss over 3–4 months appears to cause significant bone loss, while more moderate loss over six months produced little or no bone loss. That comparison is specifically about premenopausal women; the citing sentence omits that population limit and could be read as applying generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWeight loss is related to fracture risk, particularly among older adults.
“Given the well described relationship between weight loss and fracture risk, particularly among older adults (48, 49, 50), monitoring clinically relevant bone endpoints in future GLP1Ra-based therapy trials seems prudent.”
Weight reduction that is substantial (≥14%) and rapid (over 3-4 mo) is associated with significant bone loss, whereas more moderate and slower weight reduction may better preserve bone mass.
“Weight reduction that is substantial (≥14%) and rapid (over 3–4 mo) is associated with significant bone loss [71], whereas more moderate and slower weight reduction may better preserve bone mass [72].”
Bone loss with weight reduction is influenced by initial body weight, age, sex, physical activity, extent of energy restriction and protein intake, and rate of weight reduction, with older individuals and females experiencing greater bone loss.
“Bone loss is influenced by initial body weight, age, sex, physical activity, extent of energy restriction and protein intake, and rate of weight reduction, with older individuals and females experiencing greater bone loss [71].”
Intentional weight loss in overweight and obese older adults could potentially worsen sarcopenia, bone mineral density, and nutrition deficits.
“While unintentional weight loss is a known nutrition concern, intentional weight loss in overweight and obese older adults could potentially worsen sarcopenia, bone mineral density, and nutrition deficits87, 88.”
From Diabetes in Older Adults: A Consensus Report (2012) · cites this paper as [88]
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- Authors
- Shapses, S. A., & Riedt, C. S.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Shapses, Sue A
- ORCID
- Shapses, Sue A
- Venue
- The Journal of Nutrition
- Publisher
- Elsevier BV
- Published
- 2006-06
- Volume
- 136
- Issue
- 6
- Pages
- 1453-1456
- ISSN
- 0022-3166 (ISSN-L)
- PMC
- PMC4016235
- OpenAlex
- W1948270248
- Cited by
- 247
- References
- 59
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 16 · 2023: 8 · 2022: 13 · 2021: 9 · 2020: 12 · 2019: 9 · 2018: 11 · 2017: 5 · 2016: 14 · 2015: 14 · 2014: 13 · 2013: 10 · 2012: 20
- FWCI
- 14.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (AG12161, R01AG012161)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- weight loss, bone loss, osteoporosis, caloric restriction, calcium intake, hormonal regulation of bone, estrogen, leptin, glucagon-like peptide-2, insulin-like growth factor I, cortisol, adiponectin, ghrelin, physical activity, obesity, fracture risk
- MeSH terms
- Body Weight, Bone and Bones, Calcium, Child, Female, Humans, Male, Middle Aged, Obesity, Osteoporosis, Weight Loss, Body Mass Index, Postmenopause
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 ›
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