You’ve seen the ads: A hunched over old woman, looking either grouchy or sad, warns us what we’ll look like if we continue on our current course and let our bones crumble to dust. The facing photo shows a vibrant, lovely (and slightly younger) woman who was smart enough to take the medicine being advertised and avoid this nightmare. Don’t be had. Osteoporosis is a horrible disease—but you probably don’t have it, may never get it, and in order to prevent it, you do not have to take dangerous medicines.

Bones just naturally get thinner and weaker with age—just like hair gets grayer and skin gets wrinkled. This is not necessarily a sign of illness. Premature or excessive bone loss, however, is a sign of illness. Serious bone loss has some very serious consequences, and many things can increase your risk, some you might not expect: Smoking, long-term use of certain medications (antidepressants, corticosteroids, thyroid hormones, certain antacids), alcoholism and depression.

Of course, now that your chances of living (and staying healthy) into your 80s and beyond are pretty good, you’ll want to take care of your bones so you don’t break a hip at 85 and miss the qualifying round of the seniors golf tournament. But don’t let your fear of bone loss make you panic and start taking drugs you don’t feel good about in an attempt to prevent a disease you may not even be at very high risk for.

According to a recent article in the British Medical Journal, the value of drugs to prevent osteoporosis is being greatly exaggerated. The BMJ authors go so far as to suggest that conflicts of interest (many of the drug trials on osteoporosis drugs are funded by the pharmaceutical companies that make the drugs) contribute to a misleading interpretation and presentation of the data. The benefits of these drugs are actually very small in populations already at low risk. And despite the impression you may be getting from all the osteoporosis awareness campaigns, most middle-aged women are at fairly low risk of osteoporosis. The ads and the studies are designed to get you to take the drugs, not to give you an accurate understanding of your risk of the disease. Most women never experience a hip fracture (which is the worst consequence of osteoporosis), and those who do generally do not break a hip until they are in their 80s.

Another thing you won’t see much in ads placed by and studies funded by drug companies is that eating well and getting enough weight-bearing exercise have been shown in clinical trials to reduce your risk of osteoporosis as much as medication—without the dangerous side effects. Be realistic about your risk of disease and take sensible precautions. But don’t react to fear-mongering ads.

Avery Hurt is a health and science journalist. Her work appears regularly in national publications such as: Better Homes and Gardens, Newsweek, and The New Physician. She is author of Bullet With Your Name On It: What You Will Probably Die From And What You Can Do About It (Clerisy Press, 2007) and Don’t Worry, I’m Not Contagious: Your Guide to Staying Healthy in an Infectious World, due out from Clerisy, fall 2008. She is at work on her third book, on alternative medicine.