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According to a new meta-analysis, obesity increases the risk of all-cause and vertebral fractures in postmenopausal women while potentially serving as a protective factor against pelvic fractures. These results highlight the importance of weight management in mitigating fracture risks among this population.

  • Obesity correlates with a higher risk of all-cause fractures, including vertebral fractures in postmenopausal women.
  • Conversely, obesity might protect against pelvic fractures.
  • Weight regulation could be crucial for fracture prevention in postmenopausal women.

Obesity, a prevalent health issue affecting global populations, is known to amplify fracture risk in adults. However, its association with fracture risk among postmenopausal women is less clear. The current meta-analysis, published in the Annals of Medicine, aimed to clarify this relationship, focusing on postmenopausal women—a critical demographic in fracture research.

Cohort Studies Illustrate the Connection Between Obesity and Fracture Risk

Eight cohort studies involving 671,532 postmenopausal women and 40,172 fractures were analyzed. The pooled data indicates that obesity in postmenopausal women raises the risk of all-cause fracture with a relative risk (RR) of 1.18 (95% confidence interval (CI): 1.09–1.28). Moreover, obesity was found to elevate the risk of vertebral fractures (RR = 1.154, 95% CI: 1.020–1.305) while reducing the risk of pelvic fractures (RR = 0.575, 95% CI: 0.470–0.702). There was no significant difference in the risk of hip and humerus fractures among obese postmenopausal women.

Obesity and Fracture Risk: Differing Impacts on Various Fracture Sites

Contrary to previous meta-analyses which indicated a lower risk of hip fracture among obese women, this study found no statistical difference in hip fracture risk among obese postmenopausal women when compared to normal-weight women. This distinction may be due to the focus on postmenopausal women as a specific population.

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The findings also unveiled that obesity in postmenopausal women increases the risk of vertebral fractures and decreases the risk of pelvic fractures. These observations offer new perspectives for clinical prevention and treatment strategies.

Implications for Clinical Practice and Further Studies

This study emphasizes the importance of weight management for postmenopausal women to mitigate the risk of fractures, especially vertebral fractures. The findings could help clinicians devise more personalized strategies for managing obesity and associated fracture risks.

However, these results need to be interpreted with caution due to certain limitations, such as potential publication bias and difficulty in generalizing the findings. Further research is necessary to explore the risk of various fracture types in obese postmenopausal women.


Liu, H. F., Meng, D. F., Yu, P., De, J. C., & Li, H. Y. (2023). Obesity and risk of fracture in postmenopausal women: a meta-analysis of cohort studies. Annals of Medicine, 55(1), 2203515. https://doi.org/10.1080/07853890.2023.2203515