That’s one of the main reasons doctors encourage patients with anorexia to limit their physical activity. Individuals with bulimia who have stayed within the healthy weight range are generally not in significant danger of bone loss. Normal-weight patients with bulimia who have suffered from anorexia in the past often need careful bone health monitoring.

For more than 10 years we’ve worked alongside Massachusetts General Hospital neuroendocrinologists Anne Klibanski, M.D.; Steven Grinspoon, M.D.; Karen K. Miller, M.D.; and Madhusmita Misra, M.D., on an internationally renowned study of osteoporosis in anorexia nervosa. Although we have established no definitive treatments, we are making headway and have found some promising clues. Research is in progress on bisphosphonates, such as risedronate (Actonel) and alendronate (Fosamax), which have been helpful in treating bone loss in postmenopausal women.

The hormone testosterone is also under investigation for the treatment of osteopenia in individuals with anorexia. There is no evidence that birth control pills will reverse bone loss for this group of patients.

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David B. Herzog, M.D., Debra L. Franko, Ph.D., Pat Cable, RN

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David B. Herzog, M.D., is the Harvard Medical School Endowed Professor of psychiatry in the field of eating disorders at Massachusetts General Hospital and the director of the Harris Center at Massachusetts General Hospital.
Debra L. Franko, Ph.D., is a professor in the Department of Counseling and Applied Educational Psychology at Northeastern University and the associate director of the Harris Center at Massachusetts General Hospital
Pat Cable, RN, is the director of publications at the Harris Center.