[Bone loss in female patients with anorexia nervosa]

Osteoporosis is occasionally seen in young women with episodes of anorexia nervosa. To study anorectic osteopenia we have examined 10 patients aged 18 to 37 years before, during and after treatment. Treatment consisted of hospitalization for correction of underweight by tube feeding and subsequent psychotherapy. Bone-density measurements performed with high-precision, low-dose, quantitative computed tomography of the distal radius and the distal tibia before treatment showed an age-dependent pattern. Linear regression suggests a trabecular bone loss of approximately 3% per year. This loss might be caused by low estrogens, because all patients were amenorrheic. After tube-feeding periods of 27 to 89 days (5 patients), trabecular bone density of the tibia was further reduced by 10.3% (range 6-13%) below pretreatment values. One year later average trabecular bone diminution was 17.3% (range 8-28%). Such rapid bone loss may cause osteoporosis within a few years, and treatment is therefore required for prevention of this skeletal deterioration.