Hope for Women with Anorexia Nervosa Struggling with Low Bone Density

Anorexia nervosa is a serious mental health disorder characterized by a distorted body image and an intense fear of gaining weight. Individuals with anorexia nervosa often engage in extreme behaviors to control their weight and may experience physical and psychological complications as a result. Anorexia nervosa causes low bone mineral density (BMD), high bone resorption, and an increased risk of fractures. 

A clinical trial was conducted to see if off-label antiresorptive therapy with denosumab can increase BMD in women with anorexia nervosa. The research involved 30 women with anorexia nervosa who were able to walk and had low bone density at one or more sites. They were divided into two groups and given either denosumab or a placebo for one year.

The primary endpoint was postero-anterior (PA) lumbar spine aBMD (Areal Bone Mineral Density) measured by dual-energy x-ray absorptiometry. Secondary endpoints included femoral neck aBMD, tibia and radius volumetric BMD and bone microarchitecture by high-resolution peripheral quantitative CT, tibia and radius failure load by finite element analysis (FEA), and markers of bone turnover.

The results of the study showed that antiresorptive therapy with denosumab increased spine aBMD in women with anorexia nervosa. The mean increase in PA lumbar spine aBMD was 5.5% in the denosumab group compared to 2.2% in the placebo group. There was no significant difference in the change of femoral neck aBMD between the two groups.

In addition, denosumab treatment also improved bone microarchitecture, as the radial trabecular number increased, radial trabecular separation decreased, and tibial cortical porosity decreased in the denosumab group compared to the placebo group. The treatment also decreased bone turnover markers in the blood.

The study concludes that 12 months of antiresorptive therapy with denosumab can reduce bone turnover and increase spine aBMD, the site most severely affected in women with anorexia nervosa. The treatment was also well-tolerated by the participants.

It is important to note that denosumab is not currently approved for the treatment of anorexia nervosa and was used off-label in this study. Further research is needed to fully understand the potential benefits and risks of this treatment option for anorexia nervosa.

This study provides hope for women with anorexia nervosa who are struggling with low bone density and an increased risk of fractures. It highlights the importance of early intervention and treatment to prevent the long-term consequences of the disorder.

If you or someone you know is struggling with anorexia nervosa, it is important to seek help from a healthcare professional. Treatment options may include therapy, medication, and lifestyle changes to improve overall health and well-being.
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