Journal of General Internal Medicine

, Volume 34, Issue 11, pp 2333–2335 | Cite as

Overweight and Obese Have Similar Burden of Hip Fracture as Normal Weight Older Adults

  • Jennifer T. LloydEmail author
  • Shari R. Waldstein
  • Marc C. Hochberg
  • Denise L. Orwig
  • Dawn E. Alley
Concise Research Reports


The association between body weight and fracture risk is a significant public health concern as the majority of older adults are overweight or obese and have low mineral density.1 Osteoporotic fractures are projected to cost $25 billion in health care spending annually by 2025, with hip fractures accounting for over 70% of these costs.2 Post-fracture spending is 25% higher among obese individuals.3

Numerous studies have found that overweight and obesity protect against risk of hip fracture, relative to normal or underweight.1 However, Nielson et al. (2012) showed that close to half (46%) of hip fractures occurred in overweight and obese older adults using data from the 1970 to 1980s.1Even though heavier individuals may have a lower relative risk of hip fracture, they may have a similar absolute risk, particularly as the prevalence of obesity continues to increase among the aging population. The aims of this paper are to provide updated estimates of the incidence of hip...



We would like to thank the National Center for Health Statistics and Research Data Center for their assistance with accessing restricted data files. We would also like to thank Suzanne G. Wensky for instructive comments on an earlier draft of this manuscript.


This work was supported by grants from the National Institutes of Health (T32 4G000262 and R01AG028556, Jennifer Lloyd), the Robert Wood Johnson Foundation Health and Society Scholars program (Dawn Alley), as well as from the Claude D. Pepper Older Americans Independence Center (P30AG028747, Shari Waldstein).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


The statements contained herein are those of the authors and do not necessarily reflect the views or policies of the Centers for Medicare & Medicaid Services.


  1. 1.
    Nielson CM, Srikanth P, Orwoll E. Obesity and fracture in men and women: An epidemiologic perspective. J Bone Miner Res. 2012;27(1):1–10.CrossRefGoogle Scholar
  2. 2.
    Burge R, Dawson-Hughes B, Solomon DH, et al. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22(3):465–475.CrossRefGoogle Scholar
  3. 3.
    Schousboe JT, Paudel ML, Taylor BC, et al. Pre-fracture individual characteristics associated with high total health care costs after fracture. Osteoporos Int. 2017; 28(8): 889–899.CrossRefGoogle Scholar
  4. 4.
    Cawley J, Burkhauser RV. Beyond BMI: the Value of More Accurate Measures of Fatness and Obesity in Social Science Research. Cambridge: National Bureau of Economic Research; 2006:1–50.CrossRefGoogle Scholar
  5. 5.
    Leveille SG, Wee CC, Iezzoni LI. Trends in obesity and arthritis among baby boomers and their predecessors, 1971-2002. Am J Public Health. 2005;95(9):1607–1613.CrossRefGoogle Scholar
  6. 6.
    Himes CL, Reynolds SL. Effect of Obesity on Falls, Injury, and Disability. JAGS. 2012; 60:124–29.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  • Jennifer T. Lloyd
    • 1
    • 2
    Email author
  • Shari R. Waldstein
    • 3
    • 4
  • Marc C. Hochberg
    • 5
  • Denise L. Orwig
    • 4
    • 5
  • Dawn E. Alley
    • 1
  1. 1.Center for Medicare & Medicaid InnovationBaltimoreUSA
  2. 2.Centers for Medicare & Medicaid ServicesBaltimoreUSA
  3. 3.Department of PsychologyUniversity of Maryland, Baltimore CountyBaltimoreUSA
  4. 4.Doctoral Program in GerontologyUniversity of Maryland, Baltimore and Baltimore CountyBaltimoreUSA
  5. 5.Department of Epidemiology and Public HealthUniversity of MarylandBaltimoreUSA

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