TREATMENT HIGHLIGHTSEATING DISORDERSPatients with chronic anorexia nervosa are found to be at high risk for bone loss.In a prospective study, 38 patients with either anorexia nervosa or bulimia nervosa were assessed for changes in bone mineral density over an average period of 3.6 years. Bone mineral density was measured by dual energy x-ray absorptiometry. Among the other measures was body mass index (BMI).1At the final assessment (ie, an average 3.6 years after the initial assessment), patients who had not recovered from anorexia (ie, those who had chronic anorexia) had high rates of osteopenia2(54.2%) and osteoporosis2(20.8%). These chronic anorexia patients had “fast loss” of bone that averaged 3.7% per year. This bone loss is in contrast to a slight annual bone gain of 0.7%, on average, achieved by patients who had recovered from anorexia. Patients with chronic anorexia–binge eating/purging type had a greater reduction in bone mineral density (ie, bone loss) compared with patients with chronic anorexia–restricting type. Overall, the abnormal bone loss observed in the
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