Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Low bone mass in premenopausal chronic dieting obese women

A Corrigendum to this article was published on 26 August 2004


Background: Obese premenopausal women are thought to be at low risk for osteoporosis due to increased body weight and effects of estrogen on weight-bearing bone.

Objective: To examine the effect of restrained eating on obese women, we examined bone mineral density (BMD) and content (BMC) of the spine and femur in obese women who were restrained eaters, with emphasis on the relationship between BMC and determinants of bone mass, and current eating behaviors, dietary intake, physical activity, and indices of calcium regulation, bone metabolism, stress and inflammation.

Design: A total of 78 obese, Caucasian, female, restrained eaters, ages 30–45 y, were enrolled in a weight lose program. Height, weight, bone turnover markers, serum parathyroid hormone (PTH), cortisol, c-reactive protein (CRP), dietary intake, eating behaviors, physical activity, and BMD and BMC were measured.

Setting: This study was conducted at the University of California, in Davis, CA, USA.

Results: In all, 31% of women had osteopenia or osteoporosis (OSTEO). In the OSTEO group, 87.5% of women had osteoporosis or osteopenia of the lumbar spine and 12.5% of the women had osteoporosis or osteopenia in femur. A significant positive correlation between BMC and energy expenditure (r=0.256), and a significant negative correlation between BMC and number of times on a weight loss diet (r=−0.250) and cognitive restraint (r=−0.239) were observed. No significant differences were observed between OSTEO women and nonosteoporotic women for current eating behaviors, dietary intake, physical activity habits, bone turnover, calcium regulation, stress, or inflammation.

Conclusions: Obese restrained eaters are at risk for low bone mass. Prior dieting may be responsible. Chronic dieters should be encouraged to decrease their dietary restraint, develop healthy eating habits and increase physical activity.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Figure 1


  • Allison DB (1995): Handbook of Assessment Methods for Eating Behaviors and Weight-related Problems. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Barr SI, Prior JC & Vigna YM (1994): Restrained eating and ovulatory disturbances: Possible implications for bone health. Am. J. Clin. Nutr. 59, 92–97.

    Article  CAS  Google Scholar 

  • Blair SN, Haskell WL, Ho P, Paffenbarger RS, Vranizan KM, Farguhar JW & Wood PD (1985): Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am. J. Epidem. 122, 794–804.

    Article  CAS  Google Scholar 

  • Christiansen C, Riis BJ & Ridbro P (1987): Prediction of rapid bone loss in postmenopausal women. Lancet 1, 1105–1108.

    Article  CAS  Google Scholar 

  • Fogelholm M, Sievanen H, Heinonen A, Virtanen M, Uusi-Rasi K, Pasanen M & Vuori L (1997): Association between weight cycling history and bone mineral density in premenopausal women. Osteoporos. Int. 7, 354–358.

    Article  CAS  Google Scholar 

  • Fogelholm GM, Sievanen HT, Kukkonen-Harjula K & Pasanen ME (2001): Bone mineral density during reduction, maintenance and regain of body weight in premenopausal, obese women. Osteoporos. Int. 12, 199–206.

    Article  CAS  Google Scholar 

  • Gallagher KI, Jakici JM, Kiel DP, Page ML, Ferguson ES & Marcus BH (2002): Impact of weight-cycling history on bone density in obese women. Obes. Res. 10, 896–902.

    Article  Google Scholar 

  • Garner DM (1991): Eating Disorder Inventory-2 Manual. Odessa, FL: Psychological Assessment Resources, Inc.

    Google Scholar 

  • Jebb S (1997): Measurement of soft tissue composition by dual energy X-ray absorptiometry. Brit. J. Nutr. 77, 151–163.

    Article  CAS  Google Scholar 

  • Jebb S, Goldberg G, Jennings G & Elia M (1995): Dual-energy X-ray absorptiometry measurements of body composition: Effects of depth and tissue thickness, including comparisons with direct analysis. Clin. Sci. 88, 319–324.

    Article  CAS  Google Scholar 

  • Kanis J (2002): Diagnosis of osteoporosis and assessment of fracture risk. Lancet 359, 1929–1936.

    Article  Google Scholar 

  • Kleerekoper M & Nelson DA (1997): Which bone density measurement? J. Bone Miner. Res. 12, 712–714.

    Article  CAS  Google Scholar 

  • Laessle R, Tuschl RJ, Kotthaus BC & Pirke KM (1989): A comparison of the validity of three scales for the assessment of dietary restraint. J. Abnorm. Psych. 98, 304–307.

    Article  Google Scholar 

  • Madsen KL, Adams W & Van Loan MD (1998): Effects of physical activity, body weight and composition, and muscular strength on bone density in young women. Med. Sci. Sports. Exerc. 30, 114–120.

    Article  CAS  Google Scholar 

  • Polivy J, Herman CP & Howard KI (1988): Restraint Scale: Assessment of Dieting. In Dictionary of Behavioral Assessment Techniques. eds Hersen M & Bellack AS, New York: Pergamon. pp 377–380.

    Google Scholar 

  • Ricci TA, Heymsfield SB, Pierson Jr RN, Chowdhury HA & Shapses SA (2001): Moderate energy restriction increases bone resorption in obese postmenopausal women. Am. J. Clin. Nutr. 73, 347–352.

    Article  CAS  Google Scholar 

  • Stunkard AJ & Messick S (1988): The Eating Inventory. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Van Loan MD & Keim NL (2000): Influence of cognitive eating restraint on total-body measurements of bone mineral density and bone mineral content in premenopausal women 18-45 y: a cross-sectional study. Am. J. Clin. Nutr. 72, 837–843.

    Article  CAS  Google Scholar 

  • Van Loan MD, Bachrach LK, Wang MC & Crawford PB (2000): Effect of drive for thinness during adolescence on adult bone mass. J. Bone. Miner. Res. 15, S412.

    Google Scholar 

  • WHO Study Group (1994): Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis. Geneva, Switzerland: World Health Organization.

Download references


We thank the staff of the Physiology Support Laboratory and the Bioanalytical Support Laboratory of the USDA-ARS-Western Human Nutrition Research Center for their invaluable assistance. We also thank Alexandra Kazaks and Pauline Morel for their assistance during the conduct of the project. Finally, thanks to the women who participated in the project as research volunteers and made the project possible. This work was supported by Grant #1R03DK57738-01A1 from the National Institutes of Health and a cooperative agreement with the USDA-ARS-Western Human Nutrition Research Center.

Author information

Authors and Affiliations


Corresponding author

Correspondence to M D Van Loan.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bacon, L., Stern, J., Keim, N. et al. Low bone mass in premenopausal chronic dieting obese women. Eur J Clin Nutr 58, 966–971 (2004).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


This article is cited by


Quick links