Effect of Weight Change Following Intentional Weight Loss on Bone Health in Older Adults with Obesity

Abstract

Objective: This study aimed to examine change in bone mineral density (BMD) and trabecular bone score among older adult weight regainers (WR) and weight maintainers (WM).

Methods: Observational data come from 77 older adults (mean age: 67 [SD 5] years; 69% women; 70% white) with obesity (mean BMI: 33.6 [SD 3.7] kg/m2 ) who lost weight during an 18-month weight loss intervention. Total body mass and body composition, along with regional (total hip, femoral neck, lumbar spine) BMD and trabecular bone score, were measured at baseline, 18 months, and 30 months. WR (n = 36) and WM (n = 41) categories were defined as a ≥ 5% or < 5% weight gain from 18 to 30 months, respectively.

Results: Among skeletal indices, only total hip BMD was significantly reduced during the 18-month intervention period in both WRs (-3.9%; 95% CI: -5.8% to -2.0%) and WMs (-2.4%; 95% CI: -4.3% to -0.5%; P = 0.07). After adjustment for relevant baseline covariates and weight change from 0 to 18 months, 30-month change in total hip BMD was -2.6% (95% CI: -4.3% to -0.9%) and -3.9% (95% CI: -5.7% to -2.1%) among WRs and WMs, respectively (P = 0.07).

Conclusions: Loss of hip BMD persists in the year after a weight loss intervention among older adults with obesity, regardless of weight regain status.

Trial registration: ClinicalTrials.gov NCT01547182.

Conflict of interest statement

Disclosure: The authors declared no relevant conflicts of interest.

© 2019 The Obesity Society.

Figures

Figure 1.

Percent change (95% CI) in regional bone mineral density and TBS by weight regain status from 18 to 30 months (a) and from baseline to 30 months (b) Model estimates were made using a mixed-model repeated measures analysis of covariance (ANCOVA), with subject as a random effect. Covariates used in the analysis included time, intervention group assignment, age, sex/gender, race/ethnicity, baseline value of the outcome, recruitment wave (as a random effect), and further adjusting for weight change from 0-18 months.