Bariatric surgery produces substantial durable weight loss and patients who undergo Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) procedures lose 62% and 47% of excess weight, respectively [1]. Bariatric treatment of obesity also attenuates or resolves comorbidities including diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea in greater than 60% of patients [2].
Despite significant improvement in weight and comorbid conditions, there is growing concern that bariatric surgery may exert a negative effect on the skeleton by accelerating bone loss, thereby increasing bone fragility [3].
Osteoporosis and osteomalacia, resulting from defective mineralization, have been recognized as long-term complications of gastrectomy, an early model for bone change with gastric bypass [4]. Among individuals who lose weight without surgery, epidemiological evidence supports increased rates of hip bone loss in older individuals, irrespective of body mass index …show more content…
Thus, the concern of possible accelerated bone loss leading to skeletal fragility secondary to bariatric surgery is important to understand as surgical weight management continues to rise in popularity.
The mechanisms of bone loss after bariatric surgery are currently unknown but are likely multifactorial. Early explanations of bariatric surgery–induced bone loss centered on calcium and vitamin D malabsorption. RYGB bypasses the duodenum and proximal jejunum, the primary sites of calcium absorption, and may lead to malabsorption of fat soluble vitamins such as vitamin D.
Despite significant improvement in weight and comorbid conditions, there is growing concern that bariatric surgery may exert a negative effect on the skeleton by accelerating bone loss, thereby increasing bone fragility [3].
Osteoporosis and osteomalacia, resulting from defective mineralization, have been recognized as long-term complications of gastrectomy, an early model for bone change with gastric bypass [4]. Among individuals who lose weight without surgery, epidemiological evidence supports increased rates of hip bone loss in older individuals, irrespective of body mass index …show more content…
Thus, the concern of possible accelerated bone loss leading to skeletal fragility secondary to bariatric surgery is important to understand as surgical weight management continues to rise in popularity.
The mechanisms of bone loss after bariatric surgery are currently unknown but are likely multifactorial. Early explanations of bariatric surgery–induced bone loss centered on calcium and vitamin D malabsorption. RYGB bypasses the duodenum and proximal jejunum, the primary sites of calcium absorption, and may lead to malabsorption of fat soluble vitamins such as vitamin D.