
Skeletal fracture has emerged as a complication of obesity, despite normal or better bone mineral density (BMD), suggesting the issue lies in bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), which is more prevalent in obese individuals, also increases fracture risk despite normal or high BMD. Patients with both obesity and T2DM may have a worse skeletal profile due to additional bone pathology from diabetes. Currently, there are no methods for identifying high-risk individuals or preventing fractures in this subgroup. Weight loss, essential for obesity management, is associated with increased bone loss. This review discusses skeletal manifestations in obesity, its link with T2DM-related bone defects, and approaches to managing bone health in obese patients.
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