Obesity Can Rob You of Bone Density and Muscle Mass

Obese patients have a greater risk of falling and breaking bones, a syndrome that researchers at Florida State University call osteosarcopenic obesity. The syndrome is the result of an all-too-common complication of obesity—deteriorating bone density and muscle mass.

“It used to be the thinking that the heavier you were, the better your bones would be because the bones were supporting more weight,” said Jasminka Ilich-Ernst, a nutrition professor at Florida State. "But that’s only true to a certain extent.”

Ilich-Ernst outlines osteosarcopenic obesity in next month’s issue of Ageing Research Reviews. Years ago, she began searching for links between bone and muscle strength and fat mass. She said many scientists were looking at bone issues but failing to consider muscle mass and strength, as well as fat tissue.

She says that abdominal fat (which is more toxic than fat found in other places in the body) has a more negative impact on bone and muscle strength and can also boost inflammation. She said the medical community typically focuses on the impacts of obesity on the cardiovascular system and the risk for other illnesses; there isn't much focus on the impacts on bone density and muscle mass.

“We still don’t have the criteria to diagnose [osteosarcopenic obesity],” Ilich-Ernst said, noting that there are individual tests to gauge obesity, bone density, and muscle mass. "Anyone with a BMI of 30 or more is considered obese, so those above 30 might be at risk for osteosarcopenic obesity," she added.

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A Trio of Health Problems

In her article, Ilich-Ernst considered data on 200 women who had had their muscle mass, bone density, and fat composition measured. She found that about one-third of them had more than 30 percent fat tissue plus declining bone density (osteopenia) and muscle mass (sarcopenia)—an especially serious problem for older women.

She says that people tend to gain weight and lose muscle mass and bone density as they age, but gaining a substantial amount of body fat can further impair muscle and bone function.

“[The obese] have a higher risk of falling and breaking a bone or encountering other disabilities,” Ilich-Ernst said.

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Preventing or Reversing Osteosarcopenic Obesity

What, if anything, can be done to reverse bone density deterioration and muscle mass loss?

Dr. Charles W. Seltzer, a physician from Philadelphia who specializes in weight loss, said shedding pounds may help increase bone density, but the research to prove it is lacking.

“However, since losing weight is so beneficial for health regardless of bone density issues, it is wise to do so even in the absence of this research,” he said, adding that supplementing your diet with calcium, vitamin D, vitamin K2, and strontium can also help boost bone density. Age-related declines in muscle mass can be prevented or reversed with proper exercise.

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Dr. Stephen Cook, who focuses on obesity, said that bone density loss likely cannot be reversed because much of bone growth occurs during childhood and adolescence.

Exercise, supplements, and weight loss don’t appear to be able to reverse bone loss, Cook said. “[But] they might help slow down the rate of decline in bone mass,” he added.