Women who have a history of anorexia nervosa or bulimia are at an increased risk of developing osteoporosis. It is estimated that eating disorders affect approximately 0.2-1 per cent of adolescent girls and 1-4 per cent of women aged in their 20s.⁵³

Women who develop eating disorders in early adolescence, when their skeleton is in the process of growing, severely reduce their potential to achieve peak bone mass.³⁰ This can lead to the development of osteoporosis at a young age, especially if the eating disorder persists for several years. It is not uncommon for women who have had an eating disorder since their teenage years to develop osteoporosis by their early 20s. Even women who develop an eating disorder after the process of skeletal growth has been completed will have a reduction in their bone mineral density.^30,53

The mechanisms responsible for the loss of bone density in women with eating disorders are due to a combination of nutritional deficiencies and amenorrhoea (cessation of menstrual periods), which results in oestrogen deficiency.⁵³ Women with eating disorders generally stop having periods due to poor nutrition and excessive exercise routines.

In order to improve bone health in this situation, it is vital that the eating disorder is treated and that weight recovery occurs.⁵³ In addition it is also important to correct oestrogen deficiency in these women. This may require commencement of the oral contraceptive pill.⁵⁴ Weight recovery and replacement of oestrogen can improve bone mass in these women, but some women may still continue to have reduced bone mass compared to their peers.⁵³ Therefore it is important for women who have a history of (or who currently suffer from) an eating disorder to consider having a check-up for osteoporosis.

Further resources

The Jean Hailes Foundation for Women’s Health webpage on healthy eating

Butterfly Foundation - Supporting Australians with Eating Disorders

Content updated July 28, 2011