Anorexia Boosts Chance of Early Osteoporosis

There is a powerful link between anorexia and osteoporosis, a state in which bones lose mass and density and become more fragile.

Most think of osteoporosis as a problem reserved for older women. But anorexia nervosa brings the potential for significant bone loss into focus much earlier in life.

How Anorexia Increases Osteoporosis Risk

There are at least four key ways in which anorexia exaggerates bone loss, increasing the risk of osteporosis (or its less advanced relative, osteopenia).

• Anorexia often occurs during the adolescent years, when bones are normally accumulating in size. Bones typically reach peak mass in a person's early 20s. When a person struggles with anorexia, bones are not likely to reach their peak mass. If bone loss occurs later, there will be less mass to lose.
• The lack of nutrition in anorexia results in amenorrhea (the loss of the menstrual cycle) in women. Proper ovarian production is crucial to the production of estrogen, which in turn is crucial to the maintenance of bone density.
• Those with anorexia often produce high levels of the adrenal hormone cortisol, which also encourages bone loss.
• Given that a person with anorexia generally avoids calories at any cost, it's not likely that she or he will get adequate levels of calcium and vitamin D. Calcium helps the body build bone density, and vitamin D aids in the absorption of calcium.

Adding Depression to Anorexia

Depression has been shown to be an independent risk factor for osteoporosis. Over one-third of those with anorexia struggle with depression as well. A 2003 study suggests that those with anorexia and depression are more likely to develop osteoporosis than those with anorexia by itself.

Avoiding the Osteoporosis That Can Come With Anorexia

There are medications for treating osteoporosis, and exercise is helpful for stimulating bone growth. But for someone with anorexia, receiving treatment for the eating disorder is paramount. A person who has recovered from anorexia can support bone health nutritionally and (if female) will have a restored menstrual cycle. Plus, exercise is too often used by those with anorexia simply as a weight loss tool, rather than a way to become more healthy. Recovery from anorexia can help the benefits of exercise outweigh the costs.