RYGB and SG are each associated with declines in lumbar spine and hip BMD 12 months after surgery. There is greater loss of total hip and femoral neck aBMD after RYGB than SG at 12 months. There are no significant differences in lumbar spine BMD between RYGB and SG at 12 months. Vertebral and femoral MAT is increased after SG and is associated with lower weight loss and visceral fat loss.