The obesity paradox and osteoporosis

  • Angelo Fassio
  • Luca Idolazzi
  • Maurizio Rossini
  • Davide Gatti
  • Giovanni Adami
  • Alessandro Giollo
  • Ombretta Viapiana
Part of the following topical collections:
  1. Obesity Paradox


Overweight and obesity according to the definition of the WHO are considered as an abnormal or excessive fat accumulation that may impair health. Studies comparing fracture incidence in obese and non-obese individuals have demonstrated that obesity, defined on the basis of body mass index (BMI), is associated with increased risk of fracture at some sites but seems to be protective at others. The results of the studies are influenced by the distribution of BMI in the population studied; for example, in cohorts with a low prevalence of obesity, a predilection for certain fracture sites in obese individuals becomes difficult to detect, whereas, in populations with a high prevalence of obesity, previously unreported associations may emerge. Furthermore, obesity can bring with itself many complications (Type 2 diabetes mellitus, vitamin D deficiency, and motor disability) which, in the long run, can have a definite influence in terms of overall risk and quality of life, as well. This is a narrative review focusing on the relationship between bone metabolism and overweight/obesity and dealing with the fundamental dilemma of a disease (obesity) apparently associated with improved values of bone mineral density, part of a complicated relationship which revolves around obesity called “the obesity paradox”.


Obesity paradox Osteoporosis Bone metabolism Bone mineral density and obesity 


Compliance with ethical standards

Conflict of interest

The authors state that there is no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, informed consent is not required.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018
corrected ​publication May / 2018

Authors and Affiliations

  1. 1.Rheumatology UnitUniversity of VeronaVeronaItaly

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