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The Skeletal Consequences of Bariatric Surgery

  • Nutrition, Exercise and Lifestyle in Osteoporosis (S Shapses and J Lappe, Section Editors)
  • Published:
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Abstract

Purpose of Review

This review outlines the recent findings regarding the impact of bariatric surgery on bone. It explores potential mechanisms for skeletal changes following bariatric surgery and strategies for management.

Recent Findings

Bone loss following bariatric surgery is multifactorial. Probable mechanisms include skeletal unloading, abnormalities in calciotropic hormones, and changes in gut hormones. Skeletal changes that occur after bariatric surgery are specific to procedure type and persist for several years post-operatively. Studies suggest that while bone loss begins early, fracture risk may be increased later in the post-operative course, particularly after Roux-en-Y gastric bypass (RYGB).

Summary

Further research is needed to assess the extent to which skeletal changes following bariatric surgery result in fragility. Current management should be geared toward prevention of bone loss, correction of nutritional deficiencies, and incorporation of weight bearing exercise. Pharmacologic treatment should be considered for high-risk patients.

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  1. Endocrinology and Metabolic Bone Disease Service, Hospital for Special Surgery New York, New York, USA

    Alexandra N. Krez & Emily M. Stein

  2. Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA

    Emily M. Stein

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Krez, A.N., Stein, E.M. The Skeletal Consequences of Bariatric Surgery. Curr Osteoporos Rep 18, 262–272 (2020). https://doi.org/10.1007/s11914-020-00579-2

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