Clin Osteol 2026; 31(2): 87-90 | DOI: 10.36290/clo.2026.013

Anorexia nervosa and bone healthMain theme

Pavla Jelínková
Gynekologicko-porodnická klinika 2. LF UK a FNMH, Praha

Mental anorexia represents a serious psychiatric disorder with significant somatic complications. One of the most serious is a disorder of bone metabolism leading to a decrease in bone mineral density, disruption of bone microarchitecture, and an increased risk of fractures. Adolescence is a critical period for the accumulation of bone mass and the achievement of peak bone density. Energy deficit and hormonal dysregulation lead to disruption of the physiological process of bone formation and remodeling, resulting in a lifelong increased risk of osteoporosis. The aim of this review article is to summarize current knowledge on the pathophysiology of bone changes in mental anorexia, clinical consequences, diagnostics, and therapeutic options, with a particular focus on the adolescent population.

Keywords: mental anorexia, bone mineral density, peak bone mass, estradiol.

Accepted: June 12, 2026; Published: July 1, 2026  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Jelínková P. Anorexia nervosa and bone health. Clinical Osteology. 2026;31(2):87-90. doi: 10.36290/clo.2026.013.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Purchase PDF - 50 CZK
    will be unlocked 1.7.2027

    References

    1. Kabíček P, Běhounek J, Jaššová K, et al. Kostní zdraví u dospívajících dívek s mentální anorexií - pilotní studie. Čes Slov Pediatr. 2020;75(6):332-336.
    2. Miller KK, Grinspoon SK, Ciampa J, et al. Medical findings in outpatients with anorexia nervosa. Arch Intern Med. 2005;165(5):561-566. Go to original source...
    3. Frølich J, Winkler LA, Abrahamsen B, et al. Fractures in women with eating disorders - incidence, predictive factors, and the impact of disease remission: cohort study with background population controls. Int J Eat Disord. 2020;53(7):1080-1087. Go to original source...
    4. Fazeli PK. Low bone mineral density in anorexia nervosa: treatments and challenges. Clin Rev Bone Miner Metab. 2019;17(2):65-76. Go to original source...
    5. Solmi M, Correll CU, Miotto M, et al. Bone mineral density, fractures and changes in bone metabolism in eating disorders: a meta-analysis. Acta Psychiatr Scand. 2016;133(4):341-351. Go to original source...
    6. El Ghoch R, Calugi S, Dalle Grave R, et al. Impact of eating disorders on bone health: overview of systematic reviews. Nutrients. 2016;8(12):769. Go to original source...
    7. Rigotti NA, Nussbaum S, Herzog DB, et al. Osteoporosis in women with anorexia nervosa. N Engl J Med. 1984;311:1601-1606. Go to original source...
    8. Lawson EA, Miller KK, Bredella MA, et al. Hormone predictors of abnormal bone microarchitecture in women with anorexia nervosa. Bone. 2010;46(2):458-463. Go to original source...
    9. Haines MS, Parrett AW, Grey BE. Endocrine complications of anorexia nervosa. J Eat Disord. 2023;11:24. Go to original source...
    10. Faje A, Nattiv A, Herskovitz L, et al. Adolescent girls with anorexia nervosa have impaired cortical and trabecular microarchitecture and lower estimated bone strength at the distal radius. J Clin Endocrinol Metab. 2013;98(3):1290-1297. Go to original source...
    11. Qvist P, Christgau S, Pedersen BJ, et al. Circadian variation in the serum concentration of C-terminal telopeptide of type I collagen (serum CTX): effects of gender, age, menopausal status, posture, daylight, serum cortisol, and fasting. Bone. 2002;31:57-61. Go to original source...
    12. Miller KK, Grieco KA, Mulder JE, et al. Effects of risedronate on bone density in anorexia nervosa. J Clin Endocrinol Metab. 2004;89(8):3903-3906. Go to original source...
    13. Bachrach LK, Marcus R, Müller J, et al. Bone density in adolescent girls with anorexia nervosa. Pediatrics. 1990;86(4):440-447. Go to original source...
    14. Misra M, Klibanski A. Anorexia nervosa and bone. J Endocrinol. 2014;221(3):R163-R176. Go to original source...
    15. Ackerman KE, Nazem T, Chapko D, et al. Physiologic estrogen replacement prevents bone loss in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab. 2012;97(3):865-874.
    16. Golden NH, Lanzkowsky L, Schebendach J, et al. The effect of estrogen-progestin treatment on bone mineral density in anorexia nervosa. J Pediatr Adolesc Gynecol. 2002;15(3):135-143. Go to original source...
    17. Gordon CM, Ackerman KE, Berga SL, et al. Functional hypothalamic amenorrhea: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(5):1413-1439. Go to original source...
    18. Nicola ND, Soyka LA, Lee D, et al. Bone mineral density in adolescent girls with anorexia nervosa. J Pediatr. 2003;143(3):428-432.
    19. Misra M, Klibanski A. Bone health in anorexia nervosa. Curr Opin Endocrinol Diabetes Obes. 2014;21(6):445-452.
    20. Miller KK, Grieco A, Mulder J, et al. Effects of risedronate on bone density in anorexia nervosa. J Clin Endocrinol Metab. 2004;89(8):3903-3906. Go to original source...
    21. Fazeli PK, Wang IS, Miller KK, et al. Teriparatide increases bone formation in anorexia nervosa. J Clin Endocrinol Metab. 2014;99(4):1322-1329. Go to original source...
    22. Vogel H, Fuchs A, Maier C, et al. Hypoleptinemia and bone mass in anorexia nervosa. J Clin Endocrinol Metab. 2006;91(6):2120-2124.
    23. Misra M, Katzman D, Miller KK, et al. Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa. J Bone Miner Res. 2011;26(10):2368-2376. Go to original source...

    Return to the content


    Clinical Osteology

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.