Osteoporosis Is Not Inevitable — Here Is How to Stop It Before It Starts

The Myth That Could Cost You Your Bones

Most people hear "osteoporosis" and picture a frail elderly woman. That mental image, while understandable, is exactly the kind of dangerous assumption that allows a silent, potentially deadly disease to take hold undetected. Osteoporosis is often dismissed as an inevitable part of aging — but while bone mass naturally peaks in the late 20s and declines with age, the belief that this metabolic bone disease is guaranteed for everyone is a dangerous assumption, especially because osteoporosis can become deadly serious. Dr. Susan Zweig, an endocrinologist specializing in bone health at NYU Langone Health, wants to set the record straight.

Clinically classified as a "silent disease" because bone loss happens without any pain, aching, or physical warning, osteoporosis can go undetected as bone density decreases and bone tissue deteriorates, making bones increasingly fragile. Often, the first sign is a fracture caused by a minor fall or even a routine daily activity. The consequences can be devastating. Among those who suffer a hip fracture, 22% of women and 33% of men will die within one year. Less than half of those who survive a hip fracture regain their previous level of function.

It's Not Just Older Women — Not Even Close

The belief that osteoporosis is inevitable is also false: it is not inevitable, and there are steps people can take to prevent or slow bone loss. But first, the misconception about who is at risk needs to be dismantled. At least one in three women and one in five men will suffer from an osteoporotic fracture during their lifetime. About 20% of osteoporosis cases occur in men, and one in five men over 50 will experience an osteoporosis-related fracture. Bone loss is not a women's issue — it is a human one.

Women and men alike begin to lose bone in their mid-30s. As most people reach their maximum bone size and strength — known as peak bone mass — by around age 30, bone-healthy behaviors are important from an early age in order to optimize bone health and reduce the risk of developing osteoporosis later in life. That means the choices made in your 20s and 30s — what you eat, whether you exercise, whether you smoke — are quietly writing the story of your skeleton decades from now.

Hidden Risk Factors Most People Don't Know About

Beyond age and gender, a range of medical conditions and medications can accelerate bone loss in ways most patients never consider. Chronic diseases affecting the kidneys, liver, and gastrointestinal tract can lead to osteoporosis and bone loss through different mechanisms. Drugs that suppress estrogen or testosterone, as well as some seizure medications, may contribute to bone loss — meaning breast cancer and prostate cancer patients, as well as people being treated for epilepsy, may need to have their bone health monitored.

Everyday lifestyle habits carry real weight, too. Smoking and heavy alcohol consumption — more than two drinks a day for men and one for women — can increase risk of bone loss. Not getting enough nutrition, including a balanced diet rich in calcium, vitamin D, and protein, can undermine bone health. These are modifiable factors, which is precisely the point: many of the forces driving osteoporosis are within your control.

What You Can Actually Do About It

Prevention starts with awareness. Osteoporosis is commonly diagnosed using a bone mineral density test called a dual-energy X-ray absorptiometry (DXA or DEXA) scan — a painless and quick scan that assesses bone density and helps determine fracture risk. The U.S. Preventive Services Task Force recommends osteoporosis screening for women over the age of 65 and for postmenopausal women younger than 65 who are at increased risk. If you have underlying conditions or take bone-affecting medications, talk to your doctor about whether earlier screening makes sense.

On the prevention side, the fundamentals are straightforward but must be practiced consistently. You can take steps to help prevent the disease and fractures by staying physically active through weight-bearing exercises such as walking, drinking alcohol in moderation, and quitting smoking. Working with a specialist to understand prevention strategies and treatment options can help maintain skeletal health over time. The body begins losing bone quietly, long before any alarm sounds. The real danger is not the disease itself — it is assuming it could never happen to you.