Yu EW, et al. - Via a population-based retrospective cohort analysis that used Medicare claims data from January 1, 2006, to December 31, 2014, from 42,345 severely obese adults, of whom 29,624 received Roux-en-Y gastric bypass (RYGB) and 12,721 received adjustable gastric banding (AGB), researchers contrasted fracture risk following RYGB and AGB procedures in a large, nationally representative cohort enriched for elderly people. Both groups had comparable comorbidities, medication use, and healthcare utilization in the 365 days prior to the surgery. A total of 658 nonvertebral fractures were documented, over a mean (SD) follow-up of 3.5 years. Among RYGB recipients, site-specific analyses exhibited an elevated fracture risk at the hip, wrist, and pelvis. No important interactions of fracture risk with age, gender, diabetes status, or race were noted. Selectively, adults 65 years and older demonstrated comparable patterns of fracture risk to younger adults. In conclusion, a 73% increased risk of nonvertebral fracture following RYGB in comparison with AGB was observed, including increased risk of hip, wrist, and pelvis fractures. Fracture risk was consistently raised among RYGB patients vs AGB across various subgroups, and to a comparable degree among older and younger adults. Enhanced fracture risk seems to be a significant unintended consequence of RYGB.