The effect of bariatric surgery on bone Health: From mechanism to management

Obesity, a recognized and growing public health problem, is associated with increased rates of several comorbidities. Bariatric surgery is getting well promotion worldwide as an effective treatment for obesity. Numerous clinical studies have confirmed that bariatric surgery has negative effects on skeleton, causing bone loss and higher fracture risk. The severity of bone outcomes seems to be related to the degree of malabsorption varies depending on different procedures. With accumulated studies conducted, it is confirmed that bariatric surgery has detrimental effects on skeletal consequences through multiple mechanisms, mainly through mechanical unloading, nutritional deficiencies and hormonal changes. Current postoperative clinical managements concentrate in correcting nutritional deficiencies and reducing bone loss, but specific and effective therapy remains to be further explored. This review summarizes the current data regarding the bone outcomes of bariatric surgery and its mechanisms, and outlines the preventive strategies and nutritional care that may be warranted in order to attenuate bone deterioration after bariatric surgery.