Anorexia and Osteoporosis

Osteoporosis is a disease that causes bones to become fragile, increasing the risk of breaking. It can progress painlessly if not prevented or if left untreated.

"Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity."
Women are four times more likely to develop osteoporosis than men.

Risk Factors
  • Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis and broken bones are called "risk factors." Many of these risk factors include:
    • Being female
    • Older age
    • Family history of osteoporosis or broken bones
    • Being small and thin
    • Certain race/ethnicities such as Caucasian, Asian, or Hispanic/Latino although African Americans are also at risk
    • History of broken bones
    • Low sex hormones
      • Low estrogen levels in women, including menopause
      • Missing periods (amenorrhea)
      • Low levels of testosterone and estrogen in men
    • Diet
      • Low calcium intake
      • Low vitamin D intake
      • Excessive intake of protein, sodium and caffeine
    • Inactive lifestyle
    • Smoking
    • Alcohol abuse
    • Certain medications such as steroid medications, some anticonvulsants and others
    • Certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others.

The Anorexia Nervosa-Osteoporosis Link

From the National Institutes of Health's Osteoporosis and Related Bone Diseases - National Resource Center

Anorexia nervosa has significant physical consequences. Affected individuals can experience nutritional and hormonal problems that negatively impact bone density. Low body weight in females causes the body to stop producing estrogen, resulting in a condition known as amenorrhea, or absent menstrual periods. Low estrogen levels contribute to significant losses in bone density.

In addition, individuals with anorexia often produce excessive amounts of the adrenal hormone cortisol, which is known to trigger bone loss. Other problems — such as a decrease in the production of growth hormone and other growth factors, low body weight (apart from the estrogen loss it causes), calcium deficiency, and malnutrition — contribute to bone loss in girls and women with anorexia. Weight loss, restricted dietary intake, and testosterone deficiency may be responsible for the low bone density found in males with the disorder.

Studies suggest that low bone mass (osteopenia) is common in people with anorexia and that it occurs early in the course of the disease. Girls with anorexia are less likely to reach their peak bone density and therefore may be at increased risk for osteoporosis and fracture throughout life.

Helpful links:
What People With Anorexia Nervosa Need To Know About Osteoporosis
National Osteoporosis Foundation (
Bone Density Test

Sources: linked in post.