Incidence of bone loss, falls, and fractures after Roux-en-Y gastric bypass for morbid obesity

The objectives of this study were to determine the incidence of and associated risks for falls and fractures after gastric bypass surgery for morbid obesity and to determine the clinical signs of bone loss. The sample consisted of 167 individuals at a mean age of 47 years (SD = 10). Ten participants (6%) reported a decrease in height since surgery, and 33 (20%) reported a decrease in height since they were 20 years old. Eight participants (5%) reported postoperative fractures. Twenty-three participants (13.8%) reported falling once since surgery, and 34 (20.4%) reported falling two or more times since surgery. Twelve participants reported a new diagnosis of osteoporosis postoperatively, and 1 participant reported a new diagnosis of osteopenia. Sixty-seven percent (n = 112) of the participants were never advised to undergo a bone density test postoperatively. The findings from this study suggest that bone loss is a critical issue in this patient population, with 25% (n = 42) reporting a decrease in height, 8% (n = 13) reporting a new diagnosis of osteoporosis or osteopenia, and 5% (n = 8) reporting fractures during a mean postoperative interval of 2.4 years. In addition, risk for skeletal fragility is profound in this cohort of individuals, with 34% (n = 57) indicating a history of one or more falls postoperatively. The results from this study clearly indicate a need for early recognition of bone loss in this population so that timely interventions can be initiated to prevent further loss and subsequent fractures.