Telling anorexics about bone harm may spur change

Informing young women with anorexia about their future risk of developing the brittle bone disease osteoporosis may lead some to make healthy changes, such as increasing their calcium intake, new study findings suggest.

“Having a bone density measurement and the discussion around the results may lead to positive changes if approached in a sensitive and caring manner by a health provider,” Dr. Catherine M. Gordon, of Children’s Hospital Boston told Reuters Health.In her study, “many participants expressed that they recalled discussions about healthy steps to good bone health and were able to engage in some of these behaviors later when they got better psychologically.”Much of a person’s bone density is determined by genetics and research shows that people gain at least half of their bone density and peak bone mass during the adolescent years. Teen girls and young women with anorexia nervosa, however, are known to experience early bone loss and to have a higher risk of bone fracture than their peers.In fact, findings from 2001 report indicated that more than half of the non-recovered anorexic women involved in a 4-year study had significant bone loss in the spine, and more than 20 percent had osteoporosis–at an average age of about 25.Some health care professionals conduct bone mineral density tests on their anorexic patients to alert them to the effects of disordered eating on their bone health. Gordon and her team investigated the extent to which the results of such bone tests impact the eating behaviors of anorexic patients.They studied 19 women, ages 16 to 24, who had exhibited symptoms of anorexia nervosa for up to 10 years. The women either participated in focus groups or in individual hour-long interviews, answering questions similar to those posed to the focus groups.Overall, 14 women reported receiving abnormal results from their bone mineral density test, the report indicates.The experience of having their bones tested elicited a variety of reactions from the study participants. Some said they were frightened, one said she was intimidated, and another said that the need for the test was a “wake-up call,” Gordon and colleagues report in the journal, Clinics in Sports Medicine.Ten women took action upon receiving the results of their bone test. Several of these women increased their intake of calcium or calcium supplements while others said they had gained weight, started taking birth control pills to resume their menstrual cycle, or had become more compliant with their estrogen replacement therapy.”Our results demonstrate that performing bone density measurements could be an important tool in the ongoing management of patients with anorexia nervosa,” Gordon and her team write.Based on the findings, some parents may do well to ask doctors to test their anorexic daughter’s bone mineral density. “If a thoughtful discussion between a health provider and a patient stems from the experience of having a bone density measurement, the experience may ‘wake up’ a young woman as to the irreversible health consequences of the eating disorder,” Gordon explained.(Source: Clinics in Sports Medicine: Reuters Health: Charnicia E. Huggins: June 2005.)