In obese older adults undergoing weight loss, resistance and combined aerobic-resistance exercise reduce the increase in serum C-telopeptide, procollagen type 1 N-propeptide, and osteocalcin by 70–90% compared to aerobic exercise alone, indicating lower rates of bone resorption and formation.

When older adults with obesity lose weight, lifting weights or doing weight-bearing exercises puts stress on bones, which tells bone cells to stop breaking down bone and start building it up. This stops the usual spike in bone breakdown and rebuilding that happens when losing weight without exercise. The stress from lifting also blocks a signal that tells bone-eating cells to become active, while boosting signals that help bone-building cells work better.