I don't know that it helps motivate patients - they're often dealing with intolerable conflicting demands on their thoughts - but I know parents are quite interested in the longterm effects of malnourishment. Unfortunately, a lot of the problems of eating too little are invisible, but not necessarily benign: Premenopausal osteoporosis, an overlooked consequence of anorexia nervosa: "Women gain 40% to 60% of their bone mass during adolescence, a time coinciding with the peak incidence of anorexia nervosa, and they attain their peak bone mass by the time they are in their 20s."
Being diagnosed with osteopenia at age 17 was a big wake-up call for me. Very serious issue, one that people don't think about when they are setting progressively lower target weights. There's hope, though, a few years and some weight restoration later my density was back up in the normal range. Definitely a motivator to stay on the recovery wagon.ReplyDelete
It's been known for nearly 30 yrs that impaired bone acquisition, sometimes with premature bone loss, occurs in AN. I wouldn't suggest that (as the author of the paper suggests) low bone density in AN is overlooked. There has been a lot of research on this subject, some of which I have been involved in as a researcher.ReplyDelete
The problem is that no drug treatment works, because the cause of the problem is malnutrition. Patients are sometimes lulled into a sense of false security by being prescribed the oral contraceptive pill (which provides oestrogens and causes a monthly bleed, but which is totally drug induced), bisphosphonates, or calcium - none of which protect bone mass or prevent further loss.
Weight gain to a healthy level (BMI > 19) can lead to a reversal of osteopenia (but rarely osteoporosis) for individuals in their teens, 20s and sometimes 30s, but bone mass may still remain on the low side. The only effective treatment is nutritional. Patients should be told that loud and clear.
Yes, the diagnosis of osteopenia scared the s*** out of me. It took a while, but seven years later, my bone density is back in the normal range.ReplyDelete
I went from fine to osteopenia to osteoporosis so fast it was terrifying. Now I have stress fractures in both femurs (longest strongest bone in the body supposedly) and both tibias, and crushing in spine and possibly ribcage. I spent the past few years pretty much horizontal as I was too sick to do anything so they say the fractures came about because my bones became so thin they literally cracked. it's so painful and I will be in pain for the rest of my life. Iknew about the risks when i was caught up in the worst of it, and whenI was diagnosed with osteoporosis, I still could not change. i just felt even more trapped because now i could see how the ed was killing my body as much as my mind. It can be so strong that no matter how close to death you are and how high the risks of life long problems, you are that trapped. The medications now that I have regained much of my weight and gotten a lot better cannot help me as my osteoporosis is from a different reason to the usual age-related - most of the treatments apparently will not help osteo caused by malnutrition. There needs to be help way before it gets to this stage. i know supplements are useless if you aren't getting enough nutrition as your body will not direct nutrients to your bones when it needs to keep you alive with what little it has. But there has to be some way of preventing it being so bad. I never thought of any medicatons/treatments to prevent future health from my behaviour as meaning i didn't have to fight the ed as hard. The ed for me was not something that was influenced by outside things - it wasn't something that I could bargain with in that way. Telling sufferers to get better rather than starting some kind of preventative treatment for all health issues is akin to holding them hostage just as much as their ed already is.ReplyDelete