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Anorexia Nervosa and Osteoporosis

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Abstract

Patients with anorexia nervosa (AN) often experience low bone mineral density (BMD) and increased fracture risk, with low body weight and decreased gonadal function being the strongest predictors of the observed bone mineral deficit and fractures. Other metabolic disturbances have also been linked to bone loss in this group of patients, including growth hormone resistance, low insulin-like growth factor-1 (IGF-1) concentrations, low leptin concentrations, and hypercortisolemia. However, these correlations lack definitive evidence of causality. Weight restoration and resumption of menstrual function have the strongest impact on increasing BMD. Other potential treatment options include bisphosphonates and teriparatide, supported by data from small clinical trials, but these agents are not approved for the treatment of low BMD in adolescents or premenopausal women with AN.

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  1. Chermaine Hung and Marcus Muñoz have contributed equally and shared first authorship.

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  1. Department of Internal Medicine, University of Iowa, Iowa City, IA, USA

    Chermaine Hung

  2. Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Marcus Muñoz

  3. Division of Endocrinology, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA

    Amal Shibli-Rahhal

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Hung, C., Muñoz, M. & Shibli-Rahhal, A. Anorexia Nervosa and Osteoporosis. Calcif Tissue Int 110, 562–575 (2022). https://doi.org/10.1007/s00223-021-00826-3

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