Clin Osteol 2025; 30(4): 191-194

Bone changes after significant weight lossMain theme

Ludmila Brunerová
Osteologické centrum FNKV, Praha
Obezitologické centrum FNKV, Praha
Interní klinika FNKV a 3. LF UK Praha

The impact of obesity on bone mineral density (BMD) is complex. While chronically increased skeletal loading leads to elevated BMD, especially in the axial skeleton, the presence of low-grade inflammation and frequent vitamin D deficiency can negatively affect both the quantity and quality of bone. The risk of fractures in obese patients may be increased not only due to reduced bone quality but also due to impaired balance and a higher risk of falls. The technique used to measure BMD also plays a role. The gold standard - dual-energy X-ray absorptiometry (DXA) - may overestimate BMD in obese patients due to the higher volume of adipose tissue (known as the magnification effect). Significant weight loss achieved through bariatric surgery tends to have a negative impact on BMD. However, available data on pharmacotherapy do not indicate any osteological safety concerns. In accordance with current guidelines, it is advisable to adjust calcium and vitamin D supplementation based on the type of bariatric procedure and to perform biochemical and densitometric screening at regular intervals.

Keywords: obesity, BMD, fractures, bariatry, antiobesitic farmacotherapy.

Published: December 1, 2025  Show citation

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Brunerová L. Bone changes after significant weight loss. Clinical Osteology. 2025;30(4):191-194.
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