Heidi’s Presentation to the Bone Health and Osteoporosis Foundation
On January 24, 2025, I presented my expertise and experience to the Bone Health and Osteoporosis Foundation. Thank you, Michelle Jones, of Great Lakes Learning ECHO, for this honored invitation. This virtual lecture included dozens of doctors and health professionals as I addressed reduced bone mass density, which can be directly correlated to overall weight reduction, and appropriate exercise selection for bone health.
I opened my presentation, “Defining Fitness for Bone Health,” with a poll asking health professionals to eliminate a style of branded fitness (Pilates) that isn’t an actual class. Spoiler alert: it was a trick question. I included nine different and valid Pilates styles to illuminate the variants of brand-name fitness and how their professional exercise recommendations must be rephrased and specific for each patient/client. After a brief video demonstration of group-led yogic stretching transitions, I asked the audience to point out what they could see as problematic with their dynamic posture in group exercise classes. What cues could be helpful to recruit muscle engagement preventing kyphosis? Harmful?
My learner objectives for BHOF:
Understand why recommending umbrella terms like ‘yoga’ and ‘Pilates’ can be confusing and potentially harmful.
Learn alternative recommendations specific to your patients’/clients’ needs before they step into an instructor-led exercise class or do a fitness Google search.
Learn four posterior chain exercises for upper extremities, designed mindfully to pull on the bones that you can’t land on, for kyphosis prevention.
Highlight the importance of emphasizing body composition versus total weight reduction to increase bone health.
I included physical demonstrations of these exercises for maintaining bone density in the upper extremities, because A. I can’t sit still, and B. to surface how this kind of program design benefits the whole body’s coordination and function. People want to fix a symptom rather than treat the root cause. For example, I was asked, “How do you prevent falls?” That is a brilliant question. However, I responded, “I make sure someone can get up from the ground in the first place.” While fall prevention includes agility and joint stability, I work backward and assume the fall already happened, even if it hasn’t.
Following this, I presented a clinical trial. I seized this opportunity to speak to physicians on a topic that matters to me and offered an Ozempic clinical trial: Bone Health After Exercise Alone, GLP-1 Receptor Agonist Treatment, or Combination Treatment, (Simon Birk Kjær Jensen, PhD1; Victor Sørensen, MSc2; Rasmus Michael Sandsdal, MD1; et al).
This clinical trial outlined the effects of different combinations of liraglutide with and without exercise and its impact on bone mass density. Spoiler: magic weight loss injections decrease your lean mass (muscle) and bone mass density. Holy bones! Who knew 😅 and I had my soap box moment strategizing what exercise to recommend and what not to recommend.
Hint: DO NOT PRESCRIBE WEIGHT LOSS/GLP-1RAs WITHOUT ACTIVE LEAN MASS PRESERVATION!
<dramatic ballet curtsey>
At the time, I couldn’t believe this hadn’t been a topic of interest or even discussed, considering we know the long-term effects of anorexia and gastric bypass surgeries. Exactly two and a half weeks after my presentation, on February 11, 2025, BHOF emailed a new headliner for their annual convention in Capital Hilton, Washington D.C., stating, “This session will explore the relationship between obesity, weight loss, and bone health.”
And that, ladies and gentlemen, is how I made a dent in the system. Now to get paid for shifting the world in the right direction…