How old does Kathy look to you? (Click here)

Although she has lost her teeth and has the bones of an 80-year-old, when this photo was taken, Kathy was only 48 years-old. [Source: Greenfield, L. (2006). Thin. San Fransisco: Chronicle Books.]

Kathy is like many with a history of eating disorders who face an increased risk of osteoporosis. Even at a young age, patients with anorexia and bulimia dramatically increase their likelihood of developing early osteoporosis or osteopenia. Poor nutrition, low body weight and decreased estrogen production resulting from malnourishment can lead to joint pain, tooth loss and broken bones.

The International Journal of Eating Disorders reported in 2002 that anorexia patients are twice as likely as those without the illness to experience bone fractures. The findings suggest that the heightened risk remained for up to ten years and that damage caused to bone health can be permanent.

Up to 38% of anorexia patients are diagnosed with osteoporosis and more than 90% have osteopenia (a decrease in bone density). Those with bulimia and ED-NOS are also more prone to bone problems, especially if they have a history of anorexia. [Source: Yager, J. & Powers, P.S. (2007). Clinical Manual of Eating Disorders. Washington D.C: American Psychiatric Publishing, Inc.]

Unfortunately, osteoporosis is often only diagnosed from a bone scan after a fracture. Early detection is key to prevent a worsening of effects, so be sure to recommend a bone density test for your eating disorder patients. A visit to the dentist in order to access tooth decay and oral health is also generally recommended. Educate your patients about the risk of osteoporosis and eating disorders. To download a free handout from Gurze books, click here.