SynthesisThe International journal of eating disorders2016
State of the art systematic review of bone disease in anorexia nervosa.
Synthesis in The International journal of eating disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 124 citations in OpenAlex.
- The Association between Weight Gain/Restoration and Bone Mineral Density in Adolescents with Anorexia Nervosa: A Systematic Review.Nutrients · 2016Pooled it
- Effects of teriparatide on hip structure and bone microarchitecture in women with anorexia nervosa: a placebo-controlled randomized trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Trial
- Trial
- Bone densitometry findings and prevalence of osteoporosis at initial scanning in girls with anorexia nervosa.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Recovery From Anorexia Nervosa: A Concept Analysis.Journal of advanced nursing · 2026Review
- Temporal Trends in the Epidemiology of Eating Disorders Between 2000 and 2022: A Danish Register Study of Their Incidence and Comorbidities.European eating disorders review : the journal of the Eating Disorders Association · 2026Article
- Adolescents with Low Body Mass Index Are More Vulnerable to Pediatric Nondisplaced Femoral Neck Fractures.Clinics in orthopedic surgery · 2025Article
- Bone Fracture History in Women With First Episode or With Persistent Anorexia Nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2025Article
- Medical Considerations and Consequences of Eating Disorders.Focus (American Psychiatric Publishing) · 2024Review
- Practice Assessment Tool for the Care of Patients With Eating Disorders.Focus (American Psychiatric Publishing) · 2024Article
- Bone health in avoidant/restrictive food intake disorder: a narrative review.Journal of eating disorders · 2023Review
- Unique considerations for the medical care of restrictive eating disorders in children and young adolescents.Journal of eating disorders · 2023Review
- Emergency room presentations of people with anorexia nervosa.Journal of eating disorders · 2023Review
- Advances in Diagnosis and Management of Childhood OsteoporosisJournal of clinical research in pediatric endocrinology · 2022Review
- Associations between bone mineral density, body composition and amenorrhoea in females with eating disorders: a systematic review and meta-analysis.Journal of eating disorders · 2022Review
- Increased risk of somatic diseases following anorexia nervosa in a controlled nationwide cohort study.The International journal of eating disorders · 2022Article
- Anorexia nervosa: Outpatient treatment and medical management.World journal of psychiatry · 2022Review
- Bone mineral density and oxidative stress in adolescent girls with anorexia nervosa.European journal of pediatrics · 2022Article
- Absence of relationships between depression and anxiety and bone mineral density in patients hospitalized for severe anorexia nervosa.Eating and weight disorders : EWD · 2021Article
- Predictors of bone mineral density in adolescents with atypical anorexia nervosa.Journal of bone and mineral metabolism · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveLow bone mineral density (BMD) is a known consequence of anorexia nervosa (AN) and is particularly concerning during adolescence, a critical time for bone accrual. A comprehensive synthesis of available data regarding impaired bone health, its determinants, and associated management strategies in AN is currently lacking. This systematic review aims to synthesize information from key physiologic and prospective studies and trials, and provide a thorough understanding of impaired bone health in AN and its management.
methodSearch terms included "anorexia nervosa" AND "bone density" for the period 1995-2015, limited to articles in English. Papers were screened manually based on journal impact factor, sample size, age of participants, and inclusion of a control group. When necessary, we included seminal papers published before 1995.
resultsAN leads to low BMD, impaired bone quality and increased fracture risk. Important determinants are low lean mass, hypogonadism, IGF-1 deficiency, and alterations in other hormones that impact bone health. Weight gain and menses restoration are critical for improving bone outcomes in AN. Physiologic estrogen replacement as the transdermal patch was shown to increase bone accrual in one study in adolescent females with AN; however, residual deficits persist. Bisphosphonates are potentially useful in adults with AN. DISCUSSION: To date, evidence suggests that the safest and most effective strategy to improve bone health in AN is normalization of weight with restoration of menses. Pharmacotherapies that show promise include physiologic estradiol replacement (as the transdermal estradiol patch), and in adults, bisphosphonates. Further studies are necessary to determine the best strategies to normalize BMD in AN.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.