Anorexia bone damage 'irreversible'

More than half had significant bone loss in the spine

Almost all young women with anorexia have significant bone loss which is not helped by conventional treatment.

A study of 130 anorexic women in their 20s in the US found 92% had significant bone loss (ostopenia) in the spine or hips.

Almost 38% of the women suffered bone loss serious enough to be classified as osteoporosis.

But the research team from the Massachusetts General Hospital found that taking the hormone oestrogen and taking calcium or vitamin D supplements did not improve bone density.

Lead researcher, Anne Klibanski, director of the hospital's neuroendocrine unit said: "Some of these young women are experiencing bone loss comparable to that of women many decades older, despite oestrogen therapy.

"Given this severity and the prevalence of bone loss, the importance of screening all women with anorexia for osteoporosis cannot be over-emphasised."

Permanent damage

Indications are that the bone loss suffered as a complication of anorexia nervosa may be permanent.

In this study, the strongest predictor of bone loss was the woman's weight, with those weighing least showing greater levels of osteopenia.

One quarter of women in the study were on oestrogen therapy and more than half had been prescribed oestrogen previously.

Cessation of menstrual periods, a common consequence of weight loss, was reversed in some of the women taking oestrogen but the research team found the hormone had no effect on bone density.

Treatment with vitamin D supplements and with calcium, both needed for strong and healthy bones, also had no effect.

Writing in the Annals of Internal Medicine, study author, Dr Steven Grinspoon said: "It shows that regaining and maintaining a healthy weight is key to preventing or reducing bone loss."