Restrictive Eating Disorders and Skeletal Health in Adolescent Girls and Young Women

Abstract

This article reviews the effects of restrictive eating disorders on bone health. The relationship between eating disorders and amenorrhea is discussed in detail. The pathologic impact of malnutrition on bone is explored by examining the results of studies using various available imaging techniques. The multiple hormonal alterations seen in adolescents and young women with anorexia nervosa are reviewed, as well as how these alterations may influence bone turnover, density, structure, and strength. The diagnostic clinical evaluation for adolescents and young women with these disorders is also outlined. Available treatment options, including those that hold promise for efficacy, as well as those we deemed to be ineffective, are considered from both the clinical and mechanistic standpoints. Finally, future research opportunities are offered, including intriguing work in the area of fat and bone interactions.

Keywords: Amenorrhea; Anorexia nervosa; Eating disorder; Low bone mineral density; Osteoporosis.

Figures

Fig 1

Biochemical mediators of bone turnover, each which may be altered by a restrictive eating disorder.