Health, Obesity SUrgery
Does Bone Mineral Density Change After Bariatric Surgery?
Bariatric surgery has settled into the best therapeutic alternative for morbid or grade II obesity with comorbidities. The experience of skilled surgical teams has secured untoward post-operative events to be minimal. Yet in the long term, safety data are still limited.
SUMMARY: 60 SECOND READ
This article will cover-
Overview
Bone Mineral Density (BMD) is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone, although clinically it is measured by proxy according to optical density per square centimetre of bone surface upon imaging.
Bone Mineral Content (BMC) decline and increased risk of fractures has been reported as side effects of weightloss procedures for a few decades now.
The relationship between the development of metabolic bone disease and gastrointestinal surgery has been described since the 1970s and it has been recognized as a cause of osteomalacia (marked softening of your bones, most often caused by severe vitamin D deficiency) and minor-trauma related fractures.
Morbid obesity itself is related to high Bone Mineral Content (BMC) but once important weight loss is set (voluntary or involuntary), it follows abatement in Bone Mineral Density (BMD).
Cause for Decline in Bone Mineral Density Post Bariatric surgery
In case of bariatric surgeries, malabsorptive procedures have been related to disproportionate reduction of BMD, when compared to less drastic alternatives of weight reduction, such as restrictive surgeries or caloric restrictive diet.
The greater impact of mixed procedures on nutrients availability is due to reduced food intake but is also accompanied by absorptive disturbances resulting from deviations of physiologic food flow, delaying bolus mixing with pancreatic enzymes and/or biliary secretions. If principal calcium absorption sites are removed, BMC is in jeopardy and sometimes can lead to bone mass reduction.
Conclusion
In general, weight loss, achieved through dietary restriction, drugs or bariatric surgery, is associated with a significant reduction in bone mineral density (BMD) and increased bone turnover (source). In particular, the bone loss reported after non-surgical weight loss is much lower (1%-2%) (source) than that found after bariatric procedures (8%-13%) (source).
Reference:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700383/#B28
- https://pubmed.ncbi.nlm.nih.gov/31420830/
- https://asmbs.org/app/uploads/2015/01/MetabolicBoneChanges-3.2014.pdf
