Weight loss and bone mineral density
Open accessAbstract
PURPOSE OF REVIEW: Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low bone mineral density (BMD), fearing BMD will be decreased. Confusion exists concerning the effects that weight loss has on bone health. RECENT FINDINGS: Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid or large weight loss is often associated with loss of bone density, slower or smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. Although dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss. SUMMARY: Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.
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Weight 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].”
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 [67], while more moderate and slower weight reduction may better preserve bone mass [68].”
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].”
Rapid weight loss can result in a reduction in bone mineral density.
“Rapid weight loss can also result in a reduction in bone mineral density [116]”
From Symptomatic Adverse Events and Quality of Life Related to Incretin-Based Medicines for Obesity: A Systematic Review Involving >400,000 Subjects (2025) · cites this paper as [116]
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- Authors
- Hunter, G. R., Plaisance, E. P., & Fisher, G.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Hunter, Gary R.
- Venue
- Current Opinion in Endocrinology, Diabetes & Obesity
- Published
- 2014-10
- Volume
- 21
- Issue
- 5
- Pages
- 358-362
- ISSN
- 1752-296X (ISSN-L)
- PMC
- PMC4217506
- OpenAlex
- W2314896153
- Cited by
- 76
- References
- 38
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 4 · 2023: 2 · 2022: 13 · 2021: 6 · 2020: 6 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 7 · 2015: 3
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p60dk079626-05)
- National Institute on Aging (R01AG027084)
- National Heart, Lung, and Blood Institute (T32HL105349)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60-DK-079626, R01DK49779, R01DK049779, R01 DK-51684, P30-DK56336, R01DK051684, T32DK062710, P30DK056336, P30DK079626)
- National Center for Research Resources (UL1-RR-025777, MO1 RR-00032, M01RR000032)
- 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, negative energy balance, older adults, lean body mass, fat mass, resistance training, impact loading, plyometric training, calcium intake, vitamin D intake, dual-energy X-ray absorptiometry, bone health
- MeSH terms
- Calcium, Dietary, Humans, Health Knowledge, Attitudes, Practice, Obesity, Patient Compliance, Vitamin D, Vitamins, Weight Loss, Absorptiometry, Photon, Bone Density, Bone Remodeling, Bariatric Surgery, Cone-Beam Computed Tomography, Resistance Training, Diet, Western
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