Community‐based exercise does not prevent bone loss during active weight loss (WL) in older adults, according to a recent study. However, adding resistance training (RT) may help minimize long‐term hip bone loss. 187 older adults with obesity (BMI = 34.5 ± 3.7 kg/m²) and cardiovascular disease and/or metabolic syndrome were randomized to participate in an 18‐month, community‐based trial, with a follow‐up assessment at 30 months. Intervention arms included: WL alone, WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as dual X-ray absorptiometry (DXA)‐acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Researchers found:

• Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome.
• After adjustment for WL and follow‐up at 30 months, secondary analyses revealed that total hip and femoral neck aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group.
• Additionally, lumbar spine aBMD was increased in the WL and the WL + RT groups compared with the WL + AT group.