Persistent osteopenia after recovery from anorexia nervosa

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Abstract
Osteopenia is a known complication of anorexia nervosa. Most studies have focused on the features of the illness which predict bone complications. The few reports on recovery have been conflicting, with some studies suggesting restoration of normal bone mass with recovery from anorexia nervosa, while others suggest that the improvement may only be partial. This is the first report of bone density in a long-term recovered group.We measured bone density in the hip and lumbar spine in 18 recovered women, using dual energy X-ray absorptiometry.We found an unexpectedly high incidence of osteopenia, with 14 of 18 women affected. Duration of amenorrhea was the best predictor of reduced bone density. An index of the duration of recovery, relating it to the duration of illness, was also highly correlated with outcome.Our findings have implications, both for the individual and for the economic burden to society. We suggest that the use of oral contraceptives in women recovering from anorexia nervosa needs further investigation. Additional longitudinal studies are clearly warranted.

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