Anorexia and Osteoporosis

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The longer term effects of eating disorders are being better understood, specifically the relationship between anorexia and osteoporosis.

SINGAPORE - MAY 17:  A model walks the runway ...

The Fashion industry frequently searches for models that do not represent the averages of body proportion. This can create unrealistic preceptions that can at times stimulate an eating disorder. (Image credit: Getty Images via @daylife)

Anorexia nervosa (in discussion often shortened to “anorexia”) is an eating disorder based on an obsessive fear of weight gain manifested by extreme caloric deficit and malnutrition. People with this disorder believe that they are overweight even when they are not, or even underweight. The majority of individuals with this eating disorder are female, however 5 to 15% of those with the disorder are male. Many severe health problems are associated with this disorder, and in some cases the disorder can be life threatening. Many instances of the disorder begin at the onset of puberty, which can contribute to the severity of other disorders, as systems of the body are not able to develop correctly.

During onset of puberty, individuals, specifically women are nearing peak bone mass density. 90% of bone mass density is generated in the pubescent years between 10 and 20 years of age (Hightower, 2000). As anorexic individuals have compromised nutrition, many essential elements for development of healthy bone mass density never enter the body thereby cannot be assimilated. As during the pubescent years anorexia typically manifests, the great majority of individuals with this disorder will have extremely young onset of osteoporosis or osteopenia. Some even become diagnosed with this still in puberty.

Anorexia and Osteoporosis: What to do for an anorexic teenager

Anorexia and osteoporosis need to be addressed in that order, anorexia first. As the disorder is psychological, many treatment professionals do not specifically look toward, or not qualified to address the physical ramifications of extended periods of time without the proper nutrition. A return to proper nutrition must be focused on sources of naturally occurring calcium and vitamin D. Dark green leafy vegetables, and nuts, almonds specifically can deliver calcium as well as other critical nutrients for building bone mass. Also for vitamin D production, sunlight absorption is critical. The body produces vitamin D in response to sunlight in a healthy individual.

After diet is adjusted to include the proper building blocks, the body needs the stimulation to retain minerals in bone. This comes from placing load/force on the bone. This can be attained through exercise, however care must be taken not to put the recovering individual into activities where impact may be great. Even though many anorexic individuals may be young, the fact that they are osteoporotic or osteopenic can put them at greatly increased risk of fracture. Care must be taken when engaging them in exercise, and as the progressive loads that become higher with the exercises they are doing, they must focus on comfort and biofeedback to maintain safety and recover.

Hightower, L. (2000). Osteoporosis: pediatric disease with geriatric consequences. Journal of Orthopedic Nursing. Sep-Oct;19(5):59-62.




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