Bariatric surgery is used to treat severe obesity. We aimed to investigate the incidence of clinically significant bone mineral density (BMD) loss at 6 and 12 months after bariatric surgery.
Observational study performed in a specialized center for the treatment of obesity at the University Hospital of Reims, France. Surface BMD was measured by dual x-ray absorptiometry (DEXA). A reduction of > 0.03 g/cm2 was considered clinically significant.
A total of 110 patients were included. A clinically significant reduction in BMD was observed in 62.1% of patients at 6 months, and in 71.6% at 12 months after surgery. No case of osteoporosis was observed. There were four cases of osteopenia and one fracture post-surgery. BMD loss was related by univariate analysis to the reduction in body mass index (BMI) (p < 0.01), weight loss (p < 0.01), fat mass (p < 0.01), and lean mass (p < 0.01). Multivariable analysis found a significant association between the reduction in BMD and the excess weight loss percentage (odds ratio 1.11, 95% confidence interval (1.05–1.18), p < 0.001).
There was a clinically significant reduction in BMD at 6 months after surgery in over 60% of patients undergoing bariatric surgery. BMD loss is persistent over time and predominantly situated at the femoral level, and strongly associated with weight loss. Systematic vitamin and calcium supplementation, as well as follow-up by DEXA scan seems appropriate. Systematic DEXA scan pre- and post-surgery, and annually thereafter until weight has stabilized seems appropriate.
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This retrospective study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Formal consent was not required.
Conflict of Interest
Dr. Marion Geoffroy, Dr. Jan Chrusciel, Dr. Isabelle Gaubil-Kaladjian and Dr. Ana Diaz-Cives have no commercial associations that might be a conflict of interest in relation to this article.
Dr. Charlot-Lambrecht reports personal fees from Amgen, outside the submitted work.
Dr. Eschard reports personal fees from Abbvie, personal fees from BMS, personal fees from Janssen, personal fees from Lilly, personal fees from MSD, personal fees from Novartis, personal fees from Pfizer, personal fees from Roche, personal fees from Sanofi, personal fees from UCB, outside the submitted work.
Dr. Salmon reports personal fees from Abbvie, personal fees from BMS, personal fees from Janssen, personal fees from Lilly, personal fees from MSD, personal fees from Novartis, personal fees from Pfizer, personal fees from Roche, personal fees from Sanofi, personal fees from UCB, outside the submitted work.
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Geoffroy, M., Charlot-Lambrecht, I., Chrusciel, J. et al. Impact of Bariatric Surgery on Bone Mineral Density: Observational Study of 110 Patients Followed up in a Specialized Center for the Treatment of Obesity in France. OBES SURG 29, 1765–1772 (2019). https://doi.org/10.1007/s11695-019-03719-5
- Bariatric surgery
- Bone mineral density
- Fracture, obesity
- Bone densitometry