Weighted Vests: Benefits, Risks & Bone Health for Menopause & Beyond

The fitness world is buzzing about weighted vests. What began as a military training technique – “rucking,” or walking with a weighted pack – has exploded in popularity, with the global market projected to reach $313 million by 2031. Research suggests they can boost workout efficiency, but are the claims about bone health and overall fitness truly justified? Experts are weighing in, and the picture is nuanced.

Beyond Workout Efficiency: A Focus on Bone Density

The appeal of weighted vests extends beyond simply making exercise more challenging. Many are drawn to the potential for preventing bone loss, particularly during life stages like perimenopause and menopause. “The idea is that wearing a weighted vest increases the ‘load’ you have to carry and so can help you have a more efficient workout,” explains Alexa Mieses Malchuk, MD, MPH, a family physician. Alexandra Hill, PT, DPT, a physical therapist, adds that weighted vests can “modestly increase calorie expenditure and muscle engagement, as well as improve strength and stability” compared to unweighted walking.

The potential for improving bone density stems from the principle that weight-bearing exercise stimulates bone remodeling. A frequently cited 2000 study in The Journals of Gerontology found that a five-year program of jumping exercises with a weighted vest helped postmenopausal women maintain hip bone mineral density. This has fueled interest in weighted vests as a proactive measure against osteoporosis.

The INVEST in Bone Health Trial: A Closer Seem

Kristen Beavers, PhD, MPH, RD, recently led a yearlong randomized clinical trial, INVEST in Bone Health, published in JAMA Network Open, to investigate this further. The study involved 150 older adults with obesity, divided into three groups: weight loss alone, weight loss plus a weighted vest, and weight loss plus structured resistance training. Participants in the vest group were instructed to wear a vest for up to eight hours a day, weighted to match any weight they lost during the study.

Surprisingly, the researchers found that neither resistance training nor weighted vest use mitigated hip bone loss associated with weight loss. However, Beavers emphasizes that the way the vest was used in the trial differed from how many people are currently using them. “What we were trying to do was to fool your body into thinking that you were weight stable when you weren’t,” she explains. Participants in the trial were attempting to maintain a constant load on their skeletal system, even as many individuals use vests for shorter periods during specific workouts.

Menopause and the Musculoskeletal Syndrome

The potential benefits of weighted vests may be particularly relevant for women experiencing the musculoskeletal syndrome of menopause, a term coined in a 2024 review published in Climacteric. This syndrome encompasses joint pain, muscle weakness, bone loss, and fatigue associated with estrogen loss. “Weight-bearing exercise can help people maintain bone density, in general, no matter their sex, stage of life or menopausal status,” says Malchuk. “Great bone density is important for health and to reduce risk for bone fractures, especially as we age.”

Hill notes that while a weighted vest alone won’t eliminate these issues, incorporating it into a structured, progressive exercise plan may help alleviate symptoms. “More benefits are seen when a vest is used as part of a structured, progressive, weight-bearing exercise compared with simply wearing it during daily activities.”

Navigating the Risks and Considerations

Despite the potential benefits, weighted vests aren’t suitable for everyone. Hill cautions that individuals with low back pain, arthritis, neck pain, current injuries, knee pain, balance issues, or a risk of falling should avoid them. Those with osteoporosis may benefit from added load, but only under close supervision to avoid spinal compression or falls. “Listen to your body and stop use if there is new or worsening pain,” she advises.

Malchuk adds that proper use is crucial to avoid straining the back. It’s generally recommended that the vest weight be between 5% and 10% of body weight, fit snugly, and be gradually increased as strength improves. Starting with short walks and gradually increasing duration is also advised.

Guidance for Primary Care Physicians

As weighted vests become more popular, primary care physicians may encounter more patients using them. Hill suggests that physicians don’t necessarily require to recommend them as a starting point for exercise, but should be aware of their potential benefits and risks. She recommends that patients considering a weighted vest consult with a physical therapist to assess proper loading, fit, and integration into an exercise program.

Key recommendations for safe use include: starting with a lighter weight, gradually increasing the load, ensuring a snug fit with even weight distribution, and incorporating the vest into a structured exercise routine. Consistency is also key – wearing the vest during various activities, like squats or even household chores, can maximize benefits.

as Malchuk concludes, “Weighted vests are the trend of the moment but exercise for health is here to stay.”

For more information:

Kristen Beavers, PhD, MPH, RD can be reached at [email protected]. Alexandra Hill, PT, DPT, can be reached on social media at @oncopelvicpt. Alexa Mieses Malchuk, MD, MPH, can be reached at www.DrAlexaMalchukMD.com or on X or Instagram at @DralexaMM.