How do eating disorders affect bone health?
Good nutrition is critical throughout life. If you have an eating disorder, a poor diet can deprive your body of energy (calories) and many nutrients such as protein, calcium, and vitamin D that are necessary to build and maintain strong bones.
Some eating disorders result in an unhealthy body weight caused by poor nutrition, too much exercise, vomiting, and/or laxative abuse. Less weight bearing on one’s bones and the loss of the muscle that is needed to support and strengthen the skeleton may increase the risk of thinning bones.
In females, eating disorders can cause changes in hormone levels that are necessary for healthy bones. A regular menstrual cycle is an indicator of normal hormone levels. Missed menstrual periods or absence of menstrual periods may occur as a result of an eating disorder. This can interrupt bone building, can speed up bone loss, and may increase the risk of osteoporosis.
In males, it is unclear what impact eating disorders have on hormone levels but men with eating disorders may also be at risk for bone loss and osteoporosis.
If eating disorders occur during youth or young adulthood, peak bone mass can be much lower than expected. Peak bone mass is the maximum bone density (thickness) that a person will ever have, usually reached between the ages of 16 and 25. Teens with eating disorders may grow up with lower bone mass increasing the risk for osteoporosis and broken bones in adulthood. Eating disorders that occur in adulthood can lead to bone loss and may increase the risk for broken bones. Early diagnosis and treatment of eating disorders by a healthcare provider is urgent to help prevent osteoporosis and other complications of eating disorders.
If an eating disorder is treated, can bone health improve?
It is crucial to get help to diagnosis and treat eating disorders. Speak to your healthcare provider about your bone health and if you are female, be sure to discuss your menstrual history. Reaching a healthy body weight and restoring regular menstrual function often help with the recovery of bone loss over time.
The outcome of intervention is in part determined by age at the time of diagnosis and treatment. In those who have not yet achieved peak bone mass (under age 25), there is usually some improvement in bone density that occurs when normal weight, and/or in females, normal menstrual function are restored. In adults with a history of certain eating disorders, such as anorexia nervosa, lower bone density often remains following treatment.