Adolescents With Eating Disorders are Significantly Increasing Their Risk of Osteoporosis -- A Devastating Chronic Condition

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Massachusetts Department of Public Health

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BOSTON, July 13, 1998 -- As the incidence of eating disorders continues to rise in adolescents, particularly females, a dangerous side effect has come to light -- osteoporosis. The Massachusetts Department of Public Health (MDPH) aims to increase awareness among adolescents prone to osteoporosis as a result of eating disorders.

Millions of people in America suffer from disordered eating patterns, ranging from chronic dieting to more severe behaviors such as bingeing on large amounts of food followed by self induced vomiting, over use of laxatives and excessive exercise.

"We are seeing more young women than ever with eating disorders," says Catherine Gordon, pediatric endocrinologist and adolescent medicine specialist at Boston Children's Hospital. "Good nutrition is critical throughout adolescence, the body's peak bone building years. Without proper nutrition, these adolescents are entering adulthood with compromised skeletal health and an increased risk of osteoporosis."

Osteoporosis, a disease characterized by loss of bone tissue, can be brought on prematurely among people with eating disorders. According to an article issued in 1996 in the Journal of the American Medical Association (JAMA), out of a population of young patients with the severe eating disorder Anorexia Nervosa, 50 percent were diagnosed with premature osteoporosis. Due to the severe reduction of food intake characteristic of this condition, the body becomes deprived of the calcium it needs to build proper bone mass. This causes the bones to be brittle and prone to breakage. Research finds that about 40 percent of skeletal calcium should be established during teenage years and Peak Bone Mass (PBM) is reached beginning at around the age of 20 years old. Unfortunately that is the most common age for females to be afflicted with eating disorders.

The prevalence of osteoporosis among women with eating disorders is an area that researchers are just beginning to uncover. According to JAMA, long- term studies are required to assess what, if anything, can be done to reverse the damage of osteoporosis in people with eating disorders. At the present time, recognition of this dangerous trend is essential.

The MDPH is targeting youth for the prevention of osteoporosis in an effort to overcome assumptions that this disease only effects older people. "We're encouraging young women to resist striving for the emaciated 'waif look' so dominant in our media culture. Healthy young women can have strong minds, strong bodies and strong bones for life by eating well and exercising moderately," says Annie Wilde, director of the MDPH's osteoporosis awareness campaign.

Eating disorders include anorexia nervosa, a life threatening disorder in which preoccupation with dieting and thinness can lead to excessive weight loss and bulimia nervosa, a condition characterized by frequent episodes of binge eating almost always followed by purging and feelings of guilt or shame. Excessive weight loss may lead to a condition called amenorrhea (loss of menstruation). Amenorrhea puts females at increased risk of premature osteoporosis because it not only interrupts the normal bone accretion in adolescents, it also accelerates bone loss. The link between the three diagnoses of osteoporosis, amenorrhea and anorexia is referred to as the "female triad phenomenon." The presence of any one of the diagnoses is an indication to have the patient examined immediately for either of the other two conditions.

Both male and female competitive athletes, particularly those involved in weight or appearance oriented sports such as wrestling, gymnastics, competitive dance and figure skating are at risk of premature osteoporosis due to their susceptibility to eating disorders. In fact, 10 percent of Americans suffering from eating disorders are men, according to Anorexia Nervosa and Related Eating Disorders, Inc. In most cases these men are striving to achieve low body weight to remain competitive in sports such as gymnastics or wrestling.

The public can access a full range of educational materials from the Massachusetts Osteoporosis Awareness Program by calling the MDPH's toll-free osteoporosis information line at 1-800-95-BONES.

CONTACT: Rebecca Passo of BBK Communications, 617-630-4477, ext. 250