A patient with an eating disorder may be at risk for osteopenia or osteoporosis.
Risk factors for reduced bone density:
(1) male gender
(2) anorexia nervosa > bulimia (males may show significant osteopenia with bulimia)
(3) estrogen deficiency (which may be manifested as amenorrhea) in women or low testosterone in men
(4) deficiency of bone nutrients (calcium, vitamin D, protein)
(5) medications associated with osteoporosis
(6) severity of the eating disorder (low body mass and longer duration)
A patient with an eating disorder is at increased risk for fracture. Athletes with an eating disorder are at increased risk for stress fractures or fracture following fall or injury. Fractures in these patients may heal slowly or poorly.
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