Men with obesity can experience a negative association with bone mineral density even more so than women.
Although women, particularly those who are post-menopausal, are more likely to get osteoporosis, a recent study analyzed the link between fat mass and its impact on bone density in men with obesity. Findings revealed that fat mass had a moderate, negative association with bone mineral density (BMD) in men with high levels of fat, even more so than in women.
Obesity has been thought to be a protective factor against osteoporosis in women, though this theory has been challenged. Some studies find that fat mass, specifically abdominal obesity1, may actually be a risk factor, as are other comorbidities of obesity, such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol.2
The current study is based on BMD and body composition data from over 10,000 people from the National Health and Nutrition Examination Survey. There was a strong positive link between lean mass and BMD in men and women; however, fat mass was moderately negatively associated with BMD, particularly in men.
These findings suggest that people with obesity, both men and women, could benefit from osteoporosis screenings. Fortunately for men, decreased bone mass occurs more slowly than it does in women until around the age of 65. A prompt diagnosis takes on added importance if other risk factors are involved. For men, this includes age, family history, previous fractures, loss of height, and use of certain medications, including steroids, anti-depressants, and treatments for prostate cancer, among others.
Given conflicting views on the role of obesity in limiting negative outcomes from osteoporosis, recommendations for weight loss should be specific to each patient and consider the risk factors identified herein. Some data indicates intentional weight loss can result in negative skeletal health outcomes, though this appears specific to older adults with obesity. On the other hand, more recent evidence recommends strength training in combination with caloric restriction as a means of mitigating bone and muscle loss. A comprehensive Very Low Calorie Diet (VLCD) promotes this combined approach to weight loss. Prescribed at the onset of obesity, VLCDs can help prevent serious health conditions for both men and women, including complications associated with osteoporosis.