ENDO: Estrogen Alone Builds BMD After Anorexia
Anorexia nervosa is associated with decreased bone accrual rates and low BMD at a time that is typically critical for a woman to build bone mass. This could lead to fractures later in life, Misra said.
Recovery from anorexia is associated with some improvements in BMD, but residual deficits persist, she said.
Therapeutic strategies, however, have been limited. In particular, high doses of oral estrogen given in the form of oral estrogen-progesterone birth control pills have not improved BMD, possibly because the drug may suppress production of insulin-like growth factor (IGF-1), the researchers said.
Yet no studies have looked at the use of transdermal or low-dose estrogen, using doses that are physiologically similar to the amounts the body produces, which may get around the IGF-1 suppression issue.
So the researchers enrolled 110 girls, ages 12 to 18, with anorexia nervosa and matched them with 40 normal-weight girls of the same age.
Because of concern that estrogen could promote bone plate fusion, the researchers divided the girls up based on their "bone age."
Those with immature bone age were randomized to either placebo or low-dose oral ethinyl estradiol (3.75 mcg daily until six months, 7.5 mcg from then until one year, and then 11.25 mcg through 18 months).
Those with mature bone age received either placebo or transdermal estradiol (100 mcg), with cyclic progesterone, for the entire study.
Controls received no intervention except for the calcium and vitamin D supplements that were given to all patients in the study.
Misra and colleagues found that in general, all BMD measures were lower in the anorexia patients than in controls.
While changes in hip and spine BMD were lower in anorexia patients on placebo than in controls, they were comparable for those on estrogen and controls, Misra reported ( P <0.05).
Still, Misra said that estrogen therapy did not result in complete "catch up" to normal bone density measures, as the recovered patients still had lower overall bone density than controls.
"Accrual rates need to exceed that of controls in order for [anorexia patients] to catch up to normal bone mineral density," she said.
Misra noted that estrogen therapy did not cause weight gain, and there were no difference in adverse effects among any of the groups.
Though longer follow up would be needed to catch any long-term side effects, Misra noted that improvements were seen as early as six months, and increased through one year, after which the effects leveled off.
What Is Anorexia Nervosa - News
BOSTON -- For girls recovering from anorexia nervosa, estrogen therapy, either via a patch or a low dose of the hormone, may improve their bone mineral density (BMD), researchers said here.
Kristin was diagnosed with anorexia nervosa and placed in the Comprehensive Eating Disorders Program at Lucile Packard Children's Hospital at Stanford. Now 23, Kristin recently celebrated the 10-year anniversary of her hospitalization.
Professor Phillipa Hay, foundation chairwoman of mental health at the university, told the Sydney Morning Herald that as many as 80 percent of people who suffer anorexia nervosa also suffer from a compulsion towards extreme exercise.
Among the various types of eating disorders, anorexia nervosa ranks as the most serious and potentially fatal of all. There are two types of anorexia: the “restricting anorexic,” who drastically reduces their food intake and exercises excessively and
In November 2010, the American Academy of Pediatrics released a clinical report estimating that 0.5 percent of adolescent girls in the United States have anorexia nervosa, while 1 to 2 percent meet criteria for bulimia nervosa.
Five Myths About Anorexia Nervosa | Eating Disorders
Anorexia Nervosa is a serious eating disorder that’s generally identified by the pathological fear of weight gain leading to extreme weight loss. Individuals who suffer from this disorder severely limit their consumption of food, to a point where it’s impossible for them to maintain a safe and healthy body weight. In addition to this, sufferers often exhibit behavioural changes in other aspects of their lives that may be detrimental to their well being.
Anorexia Nervosa is a major eating disorder that affects in the order of 11 million people in the United States of America alone. The vast majority of those, approximately 87%, are under twenty years of age and the number of females affected is 10 times greater than the number of males, although the number of males affected is on the increase.
Despite awareness campaigns, there are still a number of myths about Anorexia Nervosa that are circulating in popular culture. The main ones are listed below.
Myth: “Anorexia Nervosa is incurable”
Fact: Anorexia Nervosa is curable. As with most illnesses, the earlier the condition is detected the better the prognosis of complete success. Research observations from around the world show that if patients undergo treatment and continue with it for the required time (this time being different for each individual) then there is every possibility of full recovery.
Myth: “People with Anorexia Nervosa don’t engage in binge eating “
Fact: This is misconception that many people have. People with anorexia may at times engage in binge eating. These bingeing episodes are followed by purging and the food that has been consumed is got rid of through the use of laxatives, vomiting, or excessive exercise.
Myth: “People with Anorexia Nervosa don’t eat”
Fact: This idea is exaggerated, particularly in the earlier stages of the condition. Though individuals who suffer from anorexia are very restrictive about the food they eat and keep to quite drastic diets, they’re human beings and therefore, need to eat to survive. Generally, in order to achieve the goal of having a slim body, anorexics stay away from foods that are high or even moderate in calories. As the condition progresses the amount of food ingested does decrease and decrease until the point where it can become life threatening. So it’s important not to wait for things to get to that point before help is sought.
What Is Anorexia Nervosa - Bookshelf
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Anorexia Nervosa - Wikipedia
User-edited article which describes the physiological, psychological, and sociological characteristics of the complex eating disorder anorexia nervosa.
Anorexia Nervosa - MedicineNet
Provides symptoms, causes, diagnosis, and treatment for anorexia nervosa.
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