The prevalence of obesity in the world is becoming alarming. Along with aging of the population, pathology of bone metabolism is also a big and often hidden, problem. The detection of obesity and calcium metabolism disorders with bone tissue damage have long be recognized as mutually aggravating factors. In our country, according to scientific research, the vitamin D deficiency has become widespread due to geographical features and climatic conditions. It is more common in obese patients than in those with a normal mass body. The prevalence of osteoporosis among obese patients is not always more pronounced than among patients with normal weight. Apparently, there are some controversial features of the pathogenesis of osteoporosis and obesity. On the one hand, adipose tissue produces a variety of protective substrates, including estrogens, which improves the state of bone tissue. On the other hand, the effect of excess weight on bone mineral density has been established in the form of a higher risk of osteopenia and bone fractures in obese individuals. In our article, we observe the effect of obesity on the state of bone metabolism, vitamin D metabolism and deposition. Due to deposition of the cholecalciferol in adipose tissue, large doses and longer saturation courses are required to correct vitamin D deficiency in overweight patients. Therapy for osteoporosis in obesity has a number of features associated with significant marrow obesity and a static load on brittle bone. In the such case, it is preferable to use the antiresorptive drugs discussed in our article.

Keywords: cholecalciferol, vitamin D, bisphosphonates, osteoporosis, calcium, obesity