A review finds that weight loss surgery can lead to brittle bones
While weight loss surgery is known to have many positive effects, including reversal of Type 2 diabetes, it could have a negative impact on bone health.
A review published in JBMR Plus notes that weight loss surgery can cause declines in bone mass and strength, and it is linked with an increased risk of bone fractures. Skeletal changes after surgery appear early and continue even after weight loss plateaus and weight stabilizes. Nutritional factors, mechanical unloading, hormonal factors, and changes in body composition and bone marrow fat may contribute to poor bone health.
Most studies have examined the effects of the gastric bypass procedure, which is the most commonly performed weight loss procedure worldwide. It was only recently overtaken by sleeve gastrectomy. Because sleeve gastrectomy is a newer procedure, its skeletal effects have not yet been well defined.
Obesity is a public health concern worldwide. If not rapidly addressed, it is predicted that in 2025, 18% of men and 21% of women will be categorized as obese. Concomitant with the rise of the body mas index there has been an increase in the number of patients who go for gastric banding or other weight loss surgeries. However this study raises a red flag about the after effects of the surgery.
The review’s findings indicate that clinical guidelines on weight loss surgery should address bone health as a priority. “Current clinical guidelines do address bone health, but most recommendations are based on low-quality evidence or expert opinion,” said co-author Dr. Anne Schafer, of the University of California, San Francisco and the San Francisco VA Health Care System. “Future studies should address strategies to avoid long-term skeletal consequences of these otherwise beneficial procedures.”
