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Cited by 45Bone health and osteoporosis researchNutrition and Health in AgingBone Metabolism and Diseases

Is Weight Loss Harmful for Skeletal Health in Obese Older Adults?

Open access
Papageorgiou, Maria, Kerschan-Schindl, Katharina, Sathyapalan, Thozhukat, Pietschmann, Peter·2020·Gerontology
DOI 10.1159/000500779
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Abstract

Purpose of Review: In view of the existing uncertainty about the implications of intentional weight loss in older obese adults, the present review (a) summarizes the available evidence from epidemiological and interventional studies concerning the effects of weight loss through lifestyle modifications on skeletal health parameters in older overweight/obese individuals, (b) proposes mechanisms that link weight loss to bone loss in this age group, and (c) identifies appropriate animal models. Main Findings and Future Directions: Based on prospective epidemiological studies, weight loss is associated with bone loss, impaired bone macro- and microstructure, and increased fracture risk in the elderly. Data from interventional studies confirm the negative effects of intentional weight loss achieved by lifestyle modifications on skeletal health outcomes in obese older individuals. These effects appear to be modest following a single weight loss attempt, but may persist in the longer term, and presumably, during subsequent weight loss efforts. Current evidence suggests that resistance exercise coupled with caloric restriction mitigates bone and muscle loss. However, alternative strategies do not exist for older individuals, especially those who are unable or unwilling to exercise. Clinical weight loss studies in obese older individuals and preclinical research in relevant animal models with obesity and osteoporosis are required. These will advance our understanding of the pathophysiology of weight-loss-associated skeletal alterations and provide evidence on how bone loss can be counteracted or prevented.

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  • The clinical consequences of muscle and bone loss include incident fracture, disability, and death.

    “where the clinical consequences of muscle and bone loss (including incident fracture, disability, and even death) are well described (9).”

    From <scp>G</scp> <scp>LP1Ra</scp> ‐based therapies and <scp>DXA</scp> ‐acquired musculoskeletal health outcomes: a focused meta‐analysis of placebo‐controlled trials (2025) · cites this paper as [9]

    The Epidemiological studies section (p. 4) links weight loss with increased fracture risk, while the Body composition section (p. 7) connects muscle mass with physical performance and fall prevention. The paper does not describe disability or death as consequences of muscle and bone loss; its Introduction (p. 3) discusses mortality in relation to weight loss, with a qualification about randomized trials. (LLM, conf=0.86)

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Research works printed but not linked: 12

  1. [17]17. men: findings from the CHAMP study. Bone. 2011;49(6):1299-305.
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Related

Authors
Papageorgiou, M., Kerschan-Schindl, K., Sathyapalan, T., & Pietschmann, P.
Affiliations
  • University of Hull (GB)
  • Medical University of Vienna (AT)
ORCID
Venue
Gerontology
Publisher
S. Karger AG
Published
2019-06-28
Volume
66
Issue
1
Pages
2-14
ISSN
  • 0304-324X (ISSN-L)
  • 1423-0003
DOI
10.1159/000500779
OpenAlex
W2955758502
Cited by
45
References
86
Citations by year
2026: 4 · 2025: 12 · 2024: 6 · 2023: 9 · 2022: 7 · 2021: 5 · 2020: 2
FWCI
0.67
Type
journal article
Language
en
Open access
Licence
Locations
  • Gerontology (publishedVersion)
  • PubMed (publishedVersion)
  • Repository@Hull (Worktribe) (University of Hull) (acceptedVersion, other-oa)
  • Repository@Hull (Worktribe) (University of Hull) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
Keywords
weight loss, obesity, older adults, bone loss, skeletal health, osteoporosis, fracture risk, lifestyle modification, caloric restriction, resistance training, muscle mass loss, bone microarchitecture, animal models of obesity
MeSH terms
Aged, Female, Humans, Life Style, Male, Obesity, Weight Loss, Exercise, Bone Density, Caloric Restriction, Overweight, Resistance Training

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