Premature bone loss and eating disorders

March 2, 2017


Doctor examining x-ray image.

Eating disorders are serious and treatable illnesses with medical and psychiatric aspects. The most recent (2013) Diagnostic and Statistical Manual of Mental Disorders (DMS-5) recognizes all the eating disorders with the most common being anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder (ARFID) and binge eating disorder as diagnosable eating disorders. Some eating disorders combine elements of multiple diagnostic classifications, these are known as “other specified feeding or eating disorder,” (OSFED).

There are long-term complications of eating disorders in adolescents and one of the most important is premature bone loss making them at risk for osteoporosis. It is estimated that  two-thirds of women who have anorexia nervosa have reduced bone mineral density and one-quarter of them might go on to develop osteoporosis. Osteoporotic fractures can occur in young adulthood.

As mentioned before, chronic malnutrition is a concern not just for females but for males as well. Chronic malnutrition can cause reduce estrogen and testosterone. Females who have chronic malnutrition might lose their menstrual cycle. Males might be fatigued and have reported decreased libido, which is related to lower testosterone levels from malnutrition.

The effects of malnutrition on the musculoskeletal system can also be seen in young athletes who may not develop an osteoporotic fracture but are at an increased risk of developing stress fractures. Young female runners or dancers who may not have all the diagnostic criteria for an eating disorder but are undernourished and are missing periods are nonetheless at increased risk of a stress fracture.

The bottom line is, eating disorders in adolescents increase the risk of osteoporosis in adulthood.

If you are concerned your child may suffer from an eating disorder, encourage them to seek professional help. Parents of children who are minors can often require that their child’s eating disorder be treated, even if the child does not want or think that professional treatment is necessary.

To learn more about Texas Children’s Eating Disorders Program, please click here.

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