This prospective, multinational GLOW cohort study (44,534 postmenopausal women ≥55 years across 10 countries) asks whether obesity actually protects against fractures — testing the widely held assumption that higher BMI reduces fracture risk in this population by tracking baseline fracture prevalence and 2-year incident fracture rates by BMI category.
When you see an obese postmenopausal woman with an ankle or lower-extremity fracture, don't dismiss it as a mechanical injury — her overall fracture rate equals that of normal-weight women, and she's far less likely to be on bone-protective therapy.
Evaluate for osteoporosis and treat accordingly; FRAX will systematically underestimate her risk due to the BMI input, so clinical judgment must compensate.
This prospective, multinational GLOW cohort study (44,534 postmenopausal women ≥55 years across 10 countries) asks whether obesity actually protects against fractures — testing the widely held assumption that higher BMI reduces fracture risk in this population by tracking baseline fracture prevalence and 2-year incident fracture rates by BMI category.
When you see an obese postmenopausal woman with an ankle or lower-extremity fracture, don't dismiss it as a mechanical injury — her overall fracture rate equals that of normal-weight women, and she's far less likely to be on bone-protective therapy.
Evaluate for osteoporosis and treat accordingly; FRAX will systematically underestimate her risk due to the BMI input, so clinical judgment must compensate.