Osteoporosis in Anorexia Nervosa

Mehler, Philip S.; Cleary, Barbara; Gaudiani, Jennifer L.

doi:10.1080/10640266.2011.551636

Cited by 39 publications

(26 citation statements)

References 18 publications

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“…[15]). The present study cannot fully support this statement while permitting a direct and more differentiated comparison of bone microarchitecture among three key groups: in young AN patients the cortical bone is only marginally affected in comparison to that of healthy young controls, whereas the degradation of the trabecular bone is comparable to that occurring in healthy late postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Are patterns of bone loss in anorexic and postmenopausal women similar? Preliminary results using high resolution peripheral computed tomography

Milos

Häuselmann

Krieg

et al. 2014

Bone

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This study intended to compare bone density and architecture in three groups of women: young women with anorexia nervosa (AN), an age-matched control group of young women, and healthy late postmenopausal women. Three-dimensional peripheral quantitative high resolution computed-tomography (HR-pQCT) at the ultradistal radius, a technology providing measures of cortical and trabecular bone density and microarchitecture, was performed in the three cohorts. Thirty-six women with AN aged 18-30years (mean duration of AN: 5.8years), 83 healthy late postmenopausal women aged 70-81 as well as 30 age-matched healthy young women were assessed. The overall cortical and trabecular bone density (D100), the absolute thickness of the cortical bone (CTh), and the absolute number of trabecules per area (TbN) were significantly lower in AN patients compared with healthy young women. The absolute number of trabecules per area (TbN) in AN and postmenopausal women was similar, but significantly lower than in healthy young women. The comparison between AN patients and post-menopausal women is of interest because the latter reach bone peak mass around the middle of the fertile age span whereas the former usually lose bone before reaching optimal bone density and structure. This study shows that bone mineral density and bone compacta thickness in AN are lower than those in controls but still higher than those in postmenopause. Bone compacta density in AN is similar as in controls. However, bone inner structure in AN is degraded to a similar extent as in postmenopause. This last finding is particularly troubling. This study showed that the degree of deterioration patterns of bone microarchitecture in AN is high, and needs to be deeply analyzed. Especially troubling is the highly significantly reduced number of trabecules in both young AN patients and in healthy late postmenopausal women, compared to healthy young controls. Keywords3D-pQCT; microarchitecture of bone; bone loss; anorexia nervosa; osteoporosis; postmenopausal women.

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Section: Discussionmentioning

confidence: 99%

Are patterns of bone loss in anorexic and postmenopausal women similar? Preliminary results using high resolution peripheral computed tomography

Milos

Häuselmann

Krieg

et al. 2014

Bone

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“…Woman who are underweight develop osteoporosis more often than overweight women, perhaps because excess body fat has a protective effect on bones (Mehler & MacKenzie, 2009;Mehler, Cleary, & Gaudiani, 2011). Physiotherapists should play a significant role in the supportive and educational management of eating disorders through exercise prescription and in psycho-education programs to explore the meaning of exercise and to clarify both the positive and the negative aspects of physical activity (Probst, 2007).…”

Section: Exercise Physical Activity Sports and Gamesmentioning

confidence: 98%

Physiotherapy for patients with anorexia nervosa

Probst

Majeweski

Albertsen³

et al. 2013

Advances in Eating Disorders

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The integration of physiotherapy as an adjunctive treatment for patients with an eating disorder within psychiatric health care and rehabilitation may sound unusual. However, physiotherapists have specific expertise in both the 'body' and 'the body in movement', two important issues integral to eating disorder pathology. Based on our clinical practice and the current body of scientific evidence, a rationale and clinical guidance for incorporating physiotherapy into treatment for patients with anorexia nervosa (AN) is presented. Two main indications for physiotherapy are proposed for patients with AN: (1) the distorted body experience with a specific focus on perception, attitudes, and behavior, and (2) the compulsive and excessive engagement in physical activity characteristic of patients with AN. Physiotherapists have a wide array of skills and are encouraged to select those techniques (e.g. relaxation, breathing exercises, awareness exercise, and exercise programs) which are most individually relevant the patient to address the distorted body experience and hyperactivity typically seen in AN.

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“…In menopausal women obesity confers a lower risk of osteoporosis, probably due to combined effects of weight-bearing and aromatization of adrenal androgens to oestrogens affecting bone metabolism. Since body weight is the most important determinant of bone density, intentional weight reduction or eating disorders such as anorexia nervosa confer an increased risk of osteoporosis, and bone loss may never recover completely even once weight is restored [20]. Also in postmenopausal women the negative impact of bone loss is not reversed when weight partially rebounds following the end of active intervention programs [21] However, in a ten year prospective observational study on postmenopausal women, the health related risks of high BMI outweighed the protective effects of high BMI on bone mass, and weight gain increased the risk of hypertension, breast cancer and diabetes [22].…”

Section: Definition and Adverse Effects Of Obesitymentioning

confidence: 99%

Healthy aging and age-adjusted nutrition and physical fitness

Hammar

Östgren

2013

Best Practice & Research Clinical Obstetrics & Gynaecol

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(154 words)The expected life span is gradually increasing worldwide. For healthy ageing there are a number of options that may be used including healthy dietary and exercise habits. To reduce or prevent obesity certain types of diet may be used that will also reduce the risk of, e.g., cardiovascular disease (CVD). Exercise reduces the risk of diseases like CVD, osteoporosis, some cancers and some mental disturbances. Decreasing a sedentary life style seems at least as important as regular exercise. Exercise can probably be tailored to reduce the risk of CVD and extent of bone loss. To insure adherence, it is important to slowly increase the frequency, duration and intensity of exercise and to find activities that suit the individual. More research has to be done in order to find the ideal modes and doses of exercise and to increase long-term adherence. Both dietary and exercise modification seem to be strong promoters of healthy ageing.Healthy aging and age adjusted nutrition and physical fitness Hammar M, Östgren CJ

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Osteoporosis in Anorexia Nervosa

Cited by 39 publications

References 18 publications

Are patterns of bone loss in anorexic and postmenopausal women similar? Preliminary results using high resolution peripheral computed tomography

Are patterns of bone loss in anorexic and postmenopausal women similar? Preliminary results using high resolution peripheral computed tomography

Physiotherapy for patients with anorexia nervosa

Healthy aging and age-adjusted nutrition and physical fitness

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