NEW YORK (Reuters Health) – Based on bone mineral density (BMD) findings, anorexia nervosa patients, particularly those who binge eat and purge, are at high risk for developing osteoporosis, according to a recent report.
Over a 3.6-year follow-up period, Dr. Stephan Zipfel, from the University of Heidelberg in Germany, and colleagues assessed the BMDs of 38 women with eating disorders. Twenty-four patients had been diagnosed with anorexia nervosa and 14 with bulimia nervosa.
At follow-up, 54.2% and 20.8% of nonrecovered anorexia patients had lumbar spine osteopenia and osteoporosis, respectively. In addition, a significant difference (p < 0.01) in BMDs was seen between chronic and recovered anorexia patients, the authors note in the November issue of The Journal of Clinical Endocrinology and Metabolism.
Binge eating/purging type anorexics had significantly lower BMDs than restricting type anorexics (p = 0.02).
Compared with a group of healthy age-matched subjects, anorexic patients had higher rates of bone resorption at baseline and at follow-up. Multivariate analysis revealed that the anorexia subtype and body mass index were the best predictors of lumbar spine BMD.
With the exception of one patient, bulimics had BMDs and bone turnover markers that were within normal limits, the researchers report.
Treatment of anorexics should continue to focus on weight restoration and normalization of eating patterns. However, the use of agents that increase bone formation should be explored in patients at risk for developing osteoporosis, the investigators state.