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Obesity, Bariatric Surgery, and Fractures
Eric Lespessailles1, Julien Paccou2, Rose-Marie Javier3
1Department of Rheumatology, Regional Hospital of Orleans, University of Orleans, Orleans, France.
The Journal of Clinical Endocrinology and Metabolism
|March 23, 2019
Summary
Obesity increases fracture risk at certain sites, contrary to previous beliefs. Bariatric surgery, especially malabsorptive procedures, further elevates fracture risk in obese patients.
Area of Science:
- Orthopedics
- Endocrinology
- Public Health
Background:
- Obesity and its comorbidities represent a significant and growing public health concern.
- Historically, obesity was thought to strengthen bones due to weight-bearing effects, but recent evidence challenges this notion.
- Epidemiologic studies indicate obesity may not fully protect against fragility fractures.
Purpose of the Study:
- To review current literature on the relationship between obesity, bariatric surgery, and fracture risk.
- To analyze risk factors and reasons for fractures in overweight and obese individuals.
- To examine the impact of bariatric surgery on bone metabolism and fracture incidence.
Main Methods:
- Literature search of published reviews and articles up to January 2018.
- In-depth analysis of relevant studies and selected references.
Main Results:
- Overweight and obesity are frequently observed in patients presenting with fractures.
- Analysis of potential risk factors contributing to fractures in obese populations.
- Discussion of the complexities in interpreting body composition changes and bone density measurements.
Conclusions:
- Adiposity-induced effects place obese individuals at risk for fractures at specific skeletal sites.
- Bariatric surgery is associated with an increased risk of fractures, particularly following malabsorptive procedures.
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