This is one where it's really helpful to read his book and take notes. Bisphosponates only stop the Osteoclasts from breaking down bone. They do nothing to encourage the Osteoblasts to make more bone. These two processes work in concert together. Breaking down old bone so that it can be replaced with new bone is a necessary process for optional bone strength. If you just stop the Osteoclasts from breaking down bone that is old/weak and really needs to be replaced, you end up with more bone, sure; but much of that bone is not healthy, strong bone. If you are fracturing a great deal, then it seems that taking bisphosphonates for a short while to help prevent further fractures is warranted. In my case, my numbers are not bad so far and I haven't suffered any fractures yet. At least this is my understanding of the material I read. I welcome other interpretations of course. This was one of the most valuable things I got out of the book, was understanding how all these medications work differently so that you can choose the one most appropriate for your individual stage, which also might mean no prescriptions medications at all.