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Unformatted text preview: Module 4 --- Article 2 TREATMENT HIGHLIGHTS EATING DISORDERS Patients 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).1 At 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 anorexia patients was not found to occur in the bulimia patients. The authors conclude that “patients with chronic anorexia nervosa, particularly of the binge eating/purging type, are at high risk for osteoporosis and may need additional therapy to prevent bone loss.” They note that, while weight restoration and normalization of eating patterns are the first line of treatment, further research may identify osteotropic agents that will increase bone formation in anorexia patients.
1 BMI = [weight in kilograms] divided by [height in meters, squared]. To calculate BMI using pounds for weight and inches for height, go to: http:// www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm. Osteopenia is defined as bone mineral density ranging from 1 to up to 2.5 standard deviations below normal; osteoporosis is defined as bone mineral density of at least 2.5 standard deviations below normal. 2 Zipfel S, Seibel MJ, Löwe B, et al. Osteoporosis in eating disorders: A follow-up study of patients with anorexia and bulimia nervosa. The Journal of Clinical Endocrinology & Metabolism, 86:5227-5233, 2001. ©Copyright 2011 MWK Publishing LLC; from The Complete Practitioner: Mental Health Applications (Vol. 5, No. 4 -- April 2002) For next article, go to next page. ...
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This note was uploaded on 02/10/2011 for the course PCO 4930 taught by Professor Neimeyer during the Spring '09 term at University of Florida.
- Spring '09