Table of ContentsView AllTable of ContentsObesity and Fracture RiskShort- & Long-Term RisksFracture PreventionFracture TreatmentAccommodations
Table of ContentsView All
View All
Table of Contents
Obesity and Fracture Risk
Short- & Long-Term Risks
Fracture Prevention
Fracture Treatment
Accommodations
Bone health andobesityhave a complicated relationship. A higherbody mass index(BMI) might mean stronger bones and lower osteoporosis risk due to increasedbone mineral density, a vital element of bone strength.On the other hand, obesity can increase your risk for fractures, especially as you get older.
Osteoporosisis a bone disease that weakens bones and makes it more likely for you to experience a fracture. Afractureis a partial or complete break in the bone.
Research suggests the skeletons of people with obesity are less strong due to the inhibition of new bone cells and bone-regulating hormones responsible for breaking down old tissue and rebuilding it.Fat cells might also interfere with the chemical processes that regulate bone health, and visceral fat (abdominal fat) seems to play a significant role in bone loss.
This article will cover the relationship between obesity and fractures, the effect of excess body fat on the bones and joints, prevention and management of fractures, and more.
recep-bg / Getty Images
Obesity and Body Mass IndexThe term “obesity” describes having too much body fat.The commonly used measurement of body fat isbody mass index (BMI). It uses a simple calculation based on the ratio of height and weight. BMI is a dated, biased measure thatdoesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.A higher BMI correlates with risks of heart disease,diabetes, high blood pressure, and certaincancers.
Obesity and Body Mass Index
The term “obesity” describes having too much body fat.The commonly used measurement of body fat isbody mass index (BMI). It uses a simple calculation based on the ratio of height and weight. BMI is a dated, biased measure thatdoesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.A higher BMI correlates with risks of heart disease,diabetes, high blood pressure, and certaincancers.
The term “obesity” describes having too much body fat.The commonly used measurement of body fat isbody mass index (BMI). It uses a simple calculation based on the ratio of height and weight. BMI is a dated, biased measure thatdoesn’t account for several factors, such as body composition, ethnicity, race, gender, and age.
Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.A higher BMI correlates with risks of heart disease,diabetes, high blood pressure, and certaincancers.
Connection Between Obesity and Fracture Risk
According to the Bone Health & Osteoporosis Foundation (BHOF), some people are at an increased risk for fractures.
You could be at risk if you are:
Women who are overweight or obese may also be at anincreased risk for broken bones. Research presented at the 2022 European Congress on Obesity found women with higher waist circumferences were more vulnerable to fractures than women at a healthy weight.However, men who were underweight (not overweight) had a greater risk for fractures.
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man,” as its sources do.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man,” as its sources do.
According to the American Academy of Orthopaedic Surgeons, children who are overweight or have obesity may also have an increased risk for fractures.This might be due to too much stress on the growth plate, which can lead to bone breaks,juvenile arthritis, and other severe bone and joint conditions. Too much weight can also impact childhood bone health and growth.
Studies, including one reported in 2022 inSports Medicine & Musculoskeletal Disorders, suggest that a higher BMI may not offer protection against all types of fractures, contradicting prior studies.These newer studies also note that conditions related to obesity (including type 2 diabetes) may contribute tobone lossand increase fracture risk, including hip and spinal fractures.
Being Underweight and Fracture RiskAdults over age 40 who are underweight may also be at an increased risk for fractures, according to a 2023Scientific Reportsarticle.That report finds that being underweight is a risk factor for fractures in people over age 40, even if they return to a healthy weight.According to the International Osteoporosis Foundation, a BMI of 19 kilograms per square meter (kg/m2) is considered underweight.People with this low BMI are at a higher risk for osteoporosis and fractures.
Being Underweight and Fracture Risk
Adults over age 40 who are underweight may also be at an increased risk for fractures, according to a 2023Scientific Reportsarticle.That report finds that being underweight is a risk factor for fractures in people over age 40, even if they return to a healthy weight.According to the International Osteoporosis Foundation, a BMI of 19 kilograms per square meter (kg/m2) is considered underweight.People with this low BMI are at a higher risk for osteoporosis and fractures.
Adults over age 40 who are underweight may also be at an increased risk for fractures, according to a 2023Scientific Reportsarticle.That report finds that being underweight is a risk factor for fractures in people over age 40, even if they return to a healthy weight.
According to the International Osteoporosis Foundation, a BMI of 19 kilograms per square meter (kg/m2) is considered underweight.People with this low BMI are at a higher risk for osteoporosis and fractures.
Effects on Joints
Your joints are the places in your body where two bones meet.They play a vital role in supporting the skeleton and in most of your body’s movements. As people age, many health factors lead to arthritic conditions, and having excess weight is a common cause.
According to the Centers for Disease Control and Prevention (CDC), weights higher than what is considered healthy (BMI of 18.5 to 24.9) are described as overweight or having obesity.A BMI of 25.0 to 29.9 puts you in the overweight range, while a BMI of 30.0 falls into the obese range.
While joint wear and tear is expected as people age, added pressure from excess weight can causecartilagedamage to occur much earlier.
Research has found that people who are overweight are twice as likely to developknee osteoarthritis, the most common type ofosteoarthritis(OA), which is arthritis that develops with age and use.People who are considered obese have a 3.1-fold to 4.7-fold increased risk for OA.
Obesity can also affect non-weight-bearing joints, such as the wrists, hands, and fingers. One 2023Bone Researchreport finds obesity is not only associated with a mechanical load on joints but also with metabolic abnormalities that lead to OA in non-weight-bearing joints.
People who are overweight or have obesity might also be at an increased risk for certain types of inflammatory arthritis, like rheumatoid arthritis (RA). RA is an autoimmune disease in which the immune system causes inflammation of thesynovial liningsof joints and other body systems.
A 2020Scientific Reportsreview looked at 13 studies and found three variables were explicitly linked to RA risk: higher BMI in middle age, BMI at age 18, and waist circumference.It is also possible to develop RA at a healthy body weight, so much of the research on RA and weight is speculative at best.
Musculoskeletal Pain and ObesityObesity is strongly linked to musculoskeletal pain—pain that affects the bones, joints, ligaments, tendons, and muscles. The joints and muscles of the lower body, including the knees, hips, thighs, ankles, and feet, are most often affected.
Musculoskeletal Pain and Obesity
Obesity is strongly linked to musculoskeletal pain—pain that affects the bones, joints, ligaments, tendons, and muscles. The joints and muscles of the lower body, including the knees, hips, thighs, ankles, and feet, are most often affected.
Short-Term and Long-Term Risks
Results from a 2017–2018 National Health and Nutrition Examination Survey (NHANES) that relied on height and weight found an estimated 42.5% of U.S. adults over age 20 had obesity, and 9% had severe obesity.Weight problems can cause both short- and long-term effects that might be resolved with weight loss.
Suchshort-term risksinclude:
Long term, obesity can lead to severe health problems, including heart disease, type 2 diabetes, stroke, some cancers, osteoporosis, and osteoarthritis.It might also cause osteosarcopenic obesity, a worsening bone density and muscle mass.Osteosarcopenic obesity can, over time, increase your risk for fractures, physical disability, and various poor health outcomes.
FRAX: A Fracture Risk Calculator
Prevention Steps Before a Fracture With Obesity
A fracture can have severe consequences, especially if you are overweight, an older adult, or have osteoporosis or osteoarthritis.A fall can lead to a severe fracture that may require surgical repair, which can make it harder to get around, make daily tasks harder, and even reduce your quality of life.
Although genetics and medical problems can contribute to weight status, diet and exercise can often help people lose and manage weight.Keeping your weight in check might reduce your risk for falls and fractures and improve your health overall. Your healthcare provider can be a helpful resource if you want to lose weight.
You will also want to be mindful of unintentional weight loss as you get older. Unintentional weight loss is sometimes associated with severe muscle loss, and weakened muscles can increase your risk for falls and fractures.
Additional ways to protect yourself against fractures include:
Treatment and Management With a Fracture and Obesity
A fracture means your bone is broken, and you need medical care.In some cases, a broken bone may require surgery to repair it. In other cases, it can be splinted or placed in a cast until the bone heals.
Should you experience a fracture, seek out medical treatment right away. If your injury is the result of trauma, call 911 or have someone take you to an emergency room. Anorthopedist(medical specialist who diagnoses and treats injures and diseases of the musculoskeletal system) can address a less severe break.
When you seek treatment, the healthcare provider will examine the broken bone and request imaging tests. Depending on the cause, you may be in the emergency room or a medical provider’s office. Imaging tests used to diagnose fractures include:
How your fracture will be treated depends on which bone and which area of the bone is affected, and what caused the break.
Treatment methods for a fracture include nonsurgical and surgical options.
Nonsurgical treatments for a fracture include:
Surgical treatments include:
Mobility, Physical Activity, and Finding Accommodations
Most people who experience a fracture can fully recover and resume regular activity after the bone heals. However, some fractures can have a longer recovery time and may lead to long-term effects. A rehabilitation plan as your bone heals can lead to a successful recovery.
Aspects of a successful recovery plan include:
If you have had a significant fracture that required surgical treatment (i.e., knee or hip surgery), you may be sent to a rehabilitation center for short-term care. At the rehabilitation center, you can access physical and occupational therapists who can assist with exercises and work with you until you can go home.
If you end up going home after surgery, you may need additional support. In-home physical therapy or a caregiver can assist you with household chores and activities of daily living until you are strong enough to attend physical therapy at a medical facility and care for yourself at home.
Summary
Being overweight or having obesity can increase your risk for bone health problems, including fractures and arthritis. Being underweight can also increase the risk of fractures.
Treatments for a fracture depend on the affected bone area and the severity of the break. They may include nonsurgical options (casting and bracing) and surgical options to repair and align a broken bone to facilitate healing. If you have had surgery, you will need a rehabilitation plan, which includes physical therapy at home or a rehab facility.
Maintaining good lifestyle habits, including healthy eating, exercising, and losing excess weight, can help you keep your bones and joints healthy and reduce your risk for fractures. If you need help losing weight, reach out to a healthcare provider. They can help you create a weight-loss plan that works best for your unique health situation.
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30 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ha J, Baek KH.Body mass index at the crossroads of osteoporosis and type 2 diabetes.Korean J Intern Med.2020;35(6):1333-1335. doi:10.3904/kjim.2020.540Shapses SA, Pop LC, Wang Y.Obesity is a concern for bone health with aging.Nutr Res. 2017;39:1-13. doi:10.1016/j.nutres.2016.12.010Harvard T.H. Chan School of Public Health.Obesity definition.National Heart, Lung, and Blood Institute.Assessing your weight and health risk.Bone Health & Osteoporosis Foundation.Are you at risk?The European Association for the Study of Obesity.Obesity linked to higher risk of broken bones in women.American Academy of Orthopaedic Surgeons.How childhood obesity impacts bone and muscle health.Liu HF, Meng DF, Yu P, De JC, Li HY.Obesity and risk of fracture in postmenopausal women: a meta-analysis of cohort studies.Ann Med. 2023;55(1):2203515. doi:10.1080/07853890.2023.2203515Park SM, Park J, Han S, et al.Underweight and risk of fractures in adults over 40 years using the nationwide claims database.Sci Rep. 2023;13(1):8013. doi:10.1038/s41598-023-34828-yInternational Osteoporosis Foundation.Osteoprosis. Risk. Check.Johns Hopkins Medicine.Anatomy of a joint.Centers for Disease Control and Prevention.Assessing your weight.Reyes C, Leyland KM, Peat G, Cooper C, Arden NK, Prieto-Alhambra D.Association between overweight and obesity and risk of clinically diagnosed knee, hip, and hand osteoarthritis: a population-based cohort study.Arthritis Rheumatol. 2016;68(8):1869-1875. doi:10.1002/art.39707Wei G, Lu K, Umar M, et al.Risk of metabolic abnormalities in osteoarthritis: a new perspective to understand its pathological mechanisms.Bone Res. 2023;11(1):63. doi:10.1038/s41413-023-00301-9Ohno T, Aune D, Heath AK.Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies.Sci Rep. 2020;10(1):16006. doi:10.1038/s41598-020-71676-6Walsh TP, Arnold JB, Evans AM, Yaxley A, Damarell RA, Shanahan EM.The association between body fat and musculoskeletal pain: a systematic review and meta-analysis.BMC Musculoskelet Disord. 2018;19(1):233. doi:10.1186/s12891-018-2137-0Fryar CD, Carroll MD, Afful J.Prevalence of overweight, obesity, and extreme obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.Gill SV.Effects of obesity class on flat ground walking and obstacle negotiation.J Musculoskelet Neuronal Interact. 2019;19(4):448-454.Harvard Health Publishing.Why weight matters when it comes to joint pain.National Heart, Lung, and Blood Institute.Obesity hypoventilation syndrome.Centers for Disease Control and Prevention.Overweight and obesity.Kelly OJ, Gilman JC, Boschiero D, Ilich JZ.Osteosarcopenic obesity: current knowledge, revised identification criteria and treatment principles.Nutrients. 2019;11(4):747. doi:10.3390/nu11040747American Academy of Orthopaedic Surgeons.Information statement: obesity and musculoskeletal care.National Heart, Lung, and Blood Institute.Overweight and obesity: treatment.Yeung SSY, Reijnierse EM, Pham VK, et al.Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis.J Cachexia Sarcopenia Muscle. 2019;10(3):485-500. doi:10.1002/jcsm.12411Bone Health & Osteoporosis Foundation.Be bone strong – weight bearing.National Institute on Aging.Osteoporosis.MedlinePlus.Broken bone.MedlinePlus.Fractures.Center for Orthopaedic Surgery & Sports Medline.A guide to bone fracture treatment.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ha J, Baek KH.Body mass index at the crossroads of osteoporosis and type 2 diabetes.Korean J Intern Med.2020;35(6):1333-1335. doi:10.3904/kjim.2020.540Shapses SA, Pop LC, Wang Y.Obesity is a concern for bone health with aging.Nutr Res. 2017;39:1-13. doi:10.1016/j.nutres.2016.12.010Harvard T.H. Chan School of Public Health.Obesity definition.National Heart, Lung, and Blood Institute.Assessing your weight and health risk.Bone Health & Osteoporosis Foundation.Are you at risk?The European Association for the Study of Obesity.Obesity linked to higher risk of broken bones in women.American Academy of Orthopaedic Surgeons.How childhood obesity impacts bone and muscle health.Liu HF, Meng DF, Yu P, De JC, Li HY.Obesity and risk of fracture in postmenopausal women: a meta-analysis of cohort studies.Ann Med. 2023;55(1):2203515. doi:10.1080/07853890.2023.2203515Park SM, Park J, Han S, et al.Underweight and risk of fractures in adults over 40 years using the nationwide claims database.Sci Rep. 2023;13(1):8013. doi:10.1038/s41598-023-34828-yInternational Osteoporosis Foundation.Osteoprosis. Risk. Check.Johns Hopkins Medicine.Anatomy of a joint.Centers for Disease Control and Prevention.Assessing your weight.Reyes C, Leyland KM, Peat G, Cooper C, Arden NK, Prieto-Alhambra D.Association between overweight and obesity and risk of clinically diagnosed knee, hip, and hand osteoarthritis: a population-based cohort study.Arthritis Rheumatol. 2016;68(8):1869-1875. doi:10.1002/art.39707Wei G, Lu K, Umar M, et al.Risk of metabolic abnormalities in osteoarthritis: a new perspective to understand its pathological mechanisms.Bone Res. 2023;11(1):63. doi:10.1038/s41413-023-00301-9Ohno T, Aune D, Heath AK.Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies.Sci Rep. 2020;10(1):16006. doi:10.1038/s41598-020-71676-6Walsh TP, Arnold JB, Evans AM, Yaxley A, Damarell RA, Shanahan EM.The association between body fat and musculoskeletal pain: a systematic review and meta-analysis.BMC Musculoskelet Disord. 2018;19(1):233. doi:10.1186/s12891-018-2137-0Fryar CD, Carroll MD, Afful J.Prevalence of overweight, obesity, and extreme obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.Gill SV.Effects of obesity class on flat ground walking and obstacle negotiation.J Musculoskelet Neuronal Interact. 2019;19(4):448-454.Harvard Health Publishing.Why weight matters when it comes to joint pain.National Heart, Lung, and Blood Institute.Obesity hypoventilation syndrome.Centers for Disease Control and Prevention.Overweight and obesity.Kelly OJ, Gilman JC, Boschiero D, Ilich JZ.Osteosarcopenic obesity: current knowledge, revised identification criteria and treatment principles.Nutrients. 2019;11(4):747. doi:10.3390/nu11040747American Academy of Orthopaedic Surgeons.Information statement: obesity and musculoskeletal care.National Heart, Lung, and Blood Institute.Overweight and obesity: treatment.Yeung SSY, Reijnierse EM, Pham VK, et al.Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis.J Cachexia Sarcopenia Muscle. 2019;10(3):485-500. doi:10.1002/jcsm.12411Bone Health & Osteoporosis Foundation.Be bone strong – weight bearing.National Institute on Aging.Osteoporosis.MedlinePlus.Broken bone.MedlinePlus.Fractures.Center for Orthopaedic Surgery & Sports Medline.A guide to bone fracture treatment.
Ha J, Baek KH.Body mass index at the crossroads of osteoporosis and type 2 diabetes.Korean J Intern Med.2020;35(6):1333-1335. doi:10.3904/kjim.2020.540
Shapses SA, Pop LC, Wang Y.Obesity is a concern for bone health with aging.Nutr Res. 2017;39:1-13. doi:10.1016/j.nutres.2016.12.010
Harvard T.H. Chan School of Public Health.Obesity definition.
National Heart, Lung, and Blood Institute.Assessing your weight and health risk.
Bone Health & Osteoporosis Foundation.Are you at risk?
The European Association for the Study of Obesity.Obesity linked to higher risk of broken bones in women.
American Academy of Orthopaedic Surgeons.How childhood obesity impacts bone and muscle health.
Liu HF, Meng DF, Yu P, De JC, Li HY.Obesity and risk of fracture in postmenopausal women: a meta-analysis of cohort studies.Ann Med. 2023;55(1):2203515. doi:10.1080/07853890.2023.2203515
Park SM, Park J, Han S, et al.Underweight and risk of fractures in adults over 40 years using the nationwide claims database.Sci Rep. 2023;13(1):8013. doi:10.1038/s41598-023-34828-y
International Osteoporosis Foundation.Osteoprosis. Risk. Check.
Johns Hopkins Medicine.Anatomy of a joint.
Centers for Disease Control and Prevention.Assessing your weight.
Reyes C, Leyland KM, Peat G, Cooper C, Arden NK, Prieto-Alhambra D.Association between overweight and obesity and risk of clinically diagnosed knee, hip, and hand osteoarthritis: a population-based cohort study.Arthritis Rheumatol. 2016;68(8):1869-1875. doi:10.1002/art.39707
Wei G, Lu K, Umar M, et al.Risk of metabolic abnormalities in osteoarthritis: a new perspective to understand its pathological mechanisms.Bone Res. 2023;11(1):63. doi:10.1038/s41413-023-00301-9
Ohno T, Aune D, Heath AK.Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies.Sci Rep. 2020;10(1):16006. doi:10.1038/s41598-020-71676-6
Walsh TP, Arnold JB, Evans AM, Yaxley A, Damarell RA, Shanahan EM.The association between body fat and musculoskeletal pain: a systematic review and meta-analysis.BMC Musculoskelet Disord. 2018;19(1):233. doi:10.1186/s12891-018-2137-0
Fryar CD, Carroll MD, Afful J.Prevalence of overweight, obesity, and extreme obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats. 2020.
Gill SV.Effects of obesity class on flat ground walking and obstacle negotiation.J Musculoskelet Neuronal Interact. 2019;19(4):448-454.
Harvard Health Publishing.Why weight matters when it comes to joint pain.
National Heart, Lung, and Blood Institute.Obesity hypoventilation syndrome.
Centers for Disease Control and Prevention.Overweight and obesity.
Kelly OJ, Gilman JC, Boschiero D, Ilich JZ.Osteosarcopenic obesity: current knowledge, revised identification criteria and treatment principles.Nutrients. 2019;11(4):747. doi:10.3390/nu11040747
American Academy of Orthopaedic Surgeons.Information statement: obesity and musculoskeletal care.
National Heart, Lung, and Blood Institute.Overweight and obesity: treatment.
Yeung SSY, Reijnierse EM, Pham VK, et al.Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis.J Cachexia Sarcopenia Muscle. 2019;10(3):485-500. doi:10.1002/jcsm.12411
Bone Health & Osteoporosis Foundation.Be bone strong – weight bearing.
National Institute on Aging.Osteoporosis.
MedlinePlus.Broken bone.
MedlinePlus.Fractures.
Center for Orthopaedic Surgery & Sports Medline.A guide to bone fracture treatment.
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