The obesity paradox and osteoporosis

Overweight and obesity according to definition of 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 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 studies are influenced by distribution of BMI in 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 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 relationship between bone metabolism and overweight/obesity and dealing with 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.