In the Journals

BMD loss fails to recover after weight regain among older adults

In a cohort of older adults who lost weight while participating in a lifestyle program, both those who went on to maintain their weight loss and those who regained weight after the program were susceptible to reductions of bone mineral density at the hip, according to findings published in Obesity.

Kristen M. Beavers

“Older adults with obesity represent a large and growing segment of the population. Many of these individuals experience repeated weight loss attempts, yet little is known about the effect of weight cycling on skeletal health,” Kristen M. Beavers, PhD, MPH, RD, assistant professor of health and exercise science at Wake Forest University in Winston-Salem, North Carolina, told Endocrine Today. “Our data add to knowledge in this area and suggest that for older adults, weight loss associated hip bone loss persists into the following year, regardless of weight regain status.”

Beavers and colleagues examined the bone health trajectories for 77 participants (mean age, 67 years; 68.8% women; mean BMI, 33.6 kg/m2) in the Cooperative Lifestyle Extension Study II. During the study, all participants experienced a reduction in weight after they were randomly assigned to regimens focusing on weight loss alone, weight loss with aerobic exercise or weight loss with resistance exercise for 18 months with follow-up through month 30. At baseline, 18 months and 30 months, the researchers measured height and weight and calculated trabecular bone score, total body fat mass, total body lean mass, and hip, femoral neck and lumbar spine BMD.

During the follow-up period, 36 participants regained at least 5% of their total body mass while 41 experienced weight fluctuations of less than 5% or maintained weight, according to the researchers, who noted that the proportions of participants who maintained and those who regained weight were similar among the regimens.

Weight loss scale and tape measure 2019 
In a cohort of older adults who lost weight while participating in a lifestyle program, both those who went on to maintain their weight loss and those who regained weight after the program were susceptible to reductions of bone mineral density at the hip.
Source: Adobe Stock

At 18 months, those who went on to regain weight experienced a 3.9% reduction in total hip BMD while those who maintained their weight loss experienced a reduction of 2.4%; during follow-up, reductions in total hip BMD remained around 3% according to the researchers. Reductions in trabecular bone score were 2.9% for those who regained weight and 1.6% for those who maintained weight. After adjustment for weight loss before follow-up, those who regained weight during follow-up experienced a 2.6% reduction in hip BMD at 30 months vs. 3.9% for those who maintained their weight.

“Results from our study suggest that among older adults, weight regain may only partially recover weight loss–induced hip bone loss. These data add to a growing body of literature in older adults suggesting that at least some of the bone lost during weight reduction is lasting,” Beavers said. “Thus, to preserve the integrity of the skeletal system, geriatricians and their patients should strive to minimize bone loss during active weight loss attempts and approach weight loss as a permanent lifestyle change.” – by Phil Neuffer

For more information:

Kristen M. Beavers, PhD, MPH, RD, can be reached at beaverkm@wfu.edu.

Disclosures: The authors report no relevant financial disclosures.

In a cohort of older adults who lost weight while participating in a lifestyle program, both those who went on to maintain their weight loss and those who regained weight after the program were susceptible to reductions of bone mineral density at the hip, according to findings published in Obesity.

Kristen M. Beavers

“Older adults with obesity represent a large and growing segment of the population. Many of these individuals experience repeated weight loss attempts, yet little is known about the effect of weight cycling on skeletal health,” Kristen M. Beavers, PhD, MPH, RD, assistant professor of health and exercise science at Wake Forest University in Winston-Salem, North Carolina, told Endocrine Today. “Our data add to knowledge in this area and suggest that for older adults, weight loss associated hip bone loss persists into the following year, regardless of weight regain status.”

Beavers and colleagues examined the bone health trajectories for 77 participants (mean age, 67 years; 68.8% women; mean BMI, 33.6 kg/m2) in the Cooperative Lifestyle Extension Study II. During the study, all participants experienced a reduction in weight after they were randomly assigned to regimens focusing on weight loss alone, weight loss with aerobic exercise or weight loss with resistance exercise for 18 months with follow-up through month 30. At baseline, 18 months and 30 months, the researchers measured height and weight and calculated trabecular bone score, total body fat mass, total body lean mass, and hip, femoral neck and lumbar spine BMD.

During the follow-up period, 36 participants regained at least 5% of their total body mass while 41 experienced weight fluctuations of less than 5% or maintained weight, according to the researchers, who noted that the proportions of participants who maintained and those who regained weight were similar among the regimens.

Weight loss scale and tape measure 2019 
In a cohort of older adults who lost weight while participating in a lifestyle program, both those who went on to maintain their weight loss and those who regained weight after the program were susceptible to reductions of bone mineral density at the hip.
Source: Adobe Stock

At 18 months, those who went on to regain weight experienced a 3.9% reduction in total hip BMD while those who maintained their weight loss experienced a reduction of 2.4%; during follow-up, reductions in total hip BMD remained around 3% according to the researchers. Reductions in trabecular bone score were 2.9% for those who regained weight and 1.6% for those who maintained weight. After adjustment for weight loss before follow-up, those who regained weight during follow-up experienced a 2.6% reduction in hip BMD at 30 months vs. 3.9% for those who maintained their weight.

“Results from our study suggest that among older adults, weight regain may only partially recover weight loss–induced hip bone loss. These data add to a growing body of literature in older adults suggesting that at least some of the bone lost during weight reduction is lasting,” Beavers said. “Thus, to preserve the integrity of the skeletal system, geriatricians and their patients should strive to minimize bone loss during active weight loss attempts and approach weight loss as a permanent lifestyle change.” – by Phil Neuffer

For more information:

Kristen M. Beavers, PhD, MPH, RD, can be reached at beaverkm@wfu.edu.

Disclosures: The authors report no relevant financial disclosures.