Osteoporosis in young people. Research and treatment in eating disorders

We still have much to learn about BMD problems in eating disorders. Much progress has been made in the past 10 years; most clinicians and many patients and their families are now aware of the problem. More research is crucial, however, the authors suggest focusing on three areas: 1. Treatment and prevention: Such studies are difficult to conduct for similar reasons to the difficulties in conducting treatment trials of therapy for AN. First, the relative rarity of the condition makes it difficult to recruit subjects; second, drop-out rates are higher because of ambivalence; and third, the population is heterogeneous both in terms of symptoms and cause. 2. Better understanding of bone turnover in AN. More studies are needed to examine turnover of bone in patients with AN using biochemical markers. In particular, prospective studies are needed to examine the effects of refeeding, weight gain, and treatments such as calcium supplementation. 3. Long-term course of bone density. It would be particularly instructive to examine this in individuals with a short or long history of AN. It would also be useful to study women approaching menopause who had an episode of AN in their teens or early twenties compared with women who were of normal weight during this period.