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Is weight loss harmful for skeletal health in obese older adults?

Papageorgiou, Maria; Kerschan-Schindl, Katharina; Sathyapalan, Thozhukat; Pietschmann, Peter


Maria Papageorgiou

Katharina Kerschan-Schindl

Thozhukat Sathyapalan

Peter Pietschmann


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.


Papageorgiou, M., Kerschan-Schindl, K., Sathyapalan, T., & Pietschmann, P. (2020). Is weight loss harmful for skeletal health in obese older adults?. Gerontology, 66(1), 2-14.

Journal Article Type Article
Acceptance Date May 6, 2019
Online Publication Date Jun 28, 2019
Publication Date Jan 1, 2020
Deposit Date Jul 2, 2019
Publicly Available Date Jun 29, 2020
Journal Gerontology
Print ISSN 0304-324X
Electronic ISSN 1423-0003
Publisher Karger Publishers
Peer Reviewed Peer Reviewed
Volume 66
Issue 1
Pages 2-14
Keywords Weight loss; Caloric restriction; Exercise; Skeletal health; Bone; Osteoporosis
Public URL
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