This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

DEXA in anorexia nervosa

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Low bone mineral density in people with anorexia nervosa

  • bone mineral density results should only be interpreted and explained to people with anorexia nervosa by a professional with the knowledge and competencies to do this

  • before measuring bone density, discuss with the person and their family members or carers why it could be useful

  • explain to people with anorexia nervosa that the main way of preventing and treating low bone mineral density is reaching and maintaining a healthy body weight or BMI for their age

  • consideration for a bone mineral density scan in the following circumstances:

    • after 1 year of underweight in children and young people, or earlier if they have bone pain or recurrent fractures

    • after 2 years of underweight in adults, or earlier if they have bone pain or recurrent fractures

  • in children and young people with faltering growth, use measures of bone density that correct for bone size (such as bone mineral apparent density [BMAD])

  • a repeat bone mineral density scan should be considered in people with ongoing persistent underweight, especially when using or deciding whether to use hormonal treatment

    • however do not repeat bone mineral density scans for people with anorexia nervosa more frequently than once per year, unless they develop bone pain or recurrent fractures

  • oral or transdermal oestrogen therapy should not routinely be offered to treat low bone mineral density in children or young people with anorexia nervosa

  • seek specialist paediatric or endocrinological advice before starting any hormonal treatment for low bone mineral density. Coordinate any treatment with the eating disorders team (1)

  • transdermal 17-beta-estradiol (with cyclic progesterone) should be considered for young women (13-17 years) with anorexia nervosa who have long-term low body weight and low bone mineral density with a bone age over 15

  • incremental physiological doses of oestrogen should be considered in young women (13-17 years) with anorexia nervosa who have delayed puberty, long-term low body weight and low bone mineral density with a bone age under 15

  • bisphosphonates should be considered for women (18 years and over) with anorexia nervosa who have long-term low body weight and low bone mineral density
    • benefits and risks (including risk of teratogenic effects) must be discussed with women before starting treatment

  • people with anorexia nervosa and osteoporosis, or related bone disorders, should be advised to avoid high-impact physical activities and activities that significantly increase the chance of falls or fractures

Reference:


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page