Anorexia and Osteoporosis
What Is Anorexia Nervosa?
Anorexia nervosa is an eating disorder characterized by an
irrational fear of weight gain. People with anorexia nervosa believe that they
are overweight even when they are extremely thin. According to the National
Institute of Mental Health, an estimated 0.5 to 3.7 percent of females have
anorexia nervosa. While the majority of people with anorexia are female, an
estimated 5 to 15 percent of people with anorexia are male.
Individuals with anorexia become obsessed with food and
severely restrict their dietary intake. The disease is associated with several
health problems and, in rare cases, even death. The disorder may begin as early
as the onset of puberty. If a girl has anorexia when she reaches puberty, her
first menstrual period is typically delayed. For girls who have already reached
puberty, menstrual periods are often infrequent or absent.
What Is Osteoporosis?
Osteoporosis is a condition in which the bones become less
dense and more likely to fracture. Fractures from osteoporosis can result in
significant pain and disability. It is a major health threat for an estimated
44 million Americans, 68 percent of whom are women.
Risk factors for developing osteoporosis include:
- being thin or having a small frame
- having a family history of the disease
- for women, being postmenopausal, having an early menopause, or
not having menstrual periods (amenorrhea)
- using certain medications, such as glucocorticoids
- not getting enough calcium
- not getting enough physical activity
- drinking too much alcohol.
Osteoporosis is a silent disease that can often be prevented.
However, if undetected, it can progress for many years without symptoms until a
fracture occurs. It has been called “a pediatric disease with geriatric
consequences,” because building healthy bones in one’s youth will help prevent
osteoporosis and fractures later in life.
The Anorexia Nervosa – Osteoporosis Link
Anorexia nervosa has significant physical consequences.
Affected individuals can experience nutritional and hormonal problems that
negatively impact bone density. Low body weight in females causes the body to
stop producing estrogen, resulting in a condition known as amenorrhea, or
absent menstrual periods. Low estrogen levels contribute to significant losses
in bone density.
In addition, individuals with anorexia often produce excessive
amounts of the adrenal hormone cortisol, which is known to trigger bone loss.
Other problems – such as a decrease in the production of growth hormone and
other growth factors, low body weight (apart from the estrogen loss it causes),
calcium deficiency, and malnutrition – contribute to bone loss in girls and
women with anorexia. Weight loss, restricted dietary intake, and testosterone
deficiency may be responsible for the low bone density found in males with the
Studies suggest that low bone mass (osteopenia) is common in
people with anorexia and that it occurs early in the course of the disease.
Girls with anorexia are less likely to reach their peak bone density and
therefore may be at increased risk for osteoporosis and fracture throughout