So I read the article claiming over diagnosis and over use of meds to reduce fractures. The article was exasperating for me. While I avoid drugs just about as much as I possibly can and have done so my entire adult life, I do want to be logical and clear headed about it. This article had something illogical and or misleadingly presented, in just about every section. For example in it's main highlighted points it listed that more fractures occur with osteopenia than osteoporosis implying - well implying what? That we should not be trying so hard to reduce fractures in those with osteoporosis? Or maybe that we should be treating osteopenia even more than osteoporosis? But the main flaw in invoking this statistic as a meaningful argument is that the likely reason for that occurring is that roughly 3.5 times more people have osteopenia than osteoporosis. So yeah, it may happen more often with osteopenia simply because more people have that level of bone thinning. Does anyone think if 3.5 times more people suddenly had osteoporosis that the fracture rates would not go up?

There are numerous examples of that kind of sloppy thinking in this paper. They state the following: "The substantive approaches to preventing hip fractures have not changed
in nearly 25 years: stop smoking, be active, and eat well. This advice works for anyone,
regardless of bone fragility, and the benefits encompass the entire human body." They seem to rate not smoking as the most powerful factor, more important than bone density they say. So their key suggestion to help the masses does not work if you are a non-smoker.
And of course it does not work for so many of us. I've never smoked, exercise a lot and eat as well as possible with food sensitivities and my bone density just keeps going down. I see the same on bone health forums all the time. People doing everything right and still they have osteoporosis. And what about hormones - I thought everyone in the medical world should know how important hormones are in having healthy bones.

One responder to the article had this suggestion: "Anyone who finds the arguments advanced by Jarvinen et al even slightly persuasive should first read the rebuttal published in Osteoporosis International (July 2015) by Dr Juliet Compston (Cambridge) before forming a personal view of the validity of Jarvinen et al's arguments." Unfortunately I could not find this rebuttal online. Of course an article you can't see is no proof but I just wanted to point out that leaders in the field were highly critical of this paper - not just yours truly.

Finally I just want to say the paper is strictly from the viewpoint of public health. As in can we cost effectively prevent fractures in large numbers of people using DXA, FRAX, and bisphosphonates. They are not considering whether you or I with our DXA scores and medical histories and how fit we are and what our balance is like and how often do we fall, could benefit from anything. They are making broad judgements for vast numbers of people which may not correspond to what's best for any given individual at all. Stop smoking, be active and eat well is just not enough.