Eating disorders and fatty bone marrow?

MRI of an anorexic patient's knee

There are an estimated 24 million Americans suffering from eating disorders, 90 percent of whom are women between 12 and 25. Identifying and treating eating disorders as early as possible is critical, as months or even years of malnutrition can take an immense toll on the body, and can result in osteoporosis, slowed growth, heart disturbances, loss of menstrual periods, depression and anxiety.

MRI of a control patient's knee

At Children’s Hospital Boston, researcher Catherine Gordon has dedicated the past two decades trying to understand the mechanism behind the bone loss seen frequently in girls with anorexia—and work out how to halt it. In a unexpected twist, her recent study found that people with anorexia nervosa have strikingly high levels of fat within their bone marrow. This finding, published in the Journal of Bone and Mineral Research may help explain why people with anorexia lose bone mass, sometimes to the point of developing osteoporosis and fractures.

“It’s counter-intuitive that an emaciated young woman with almost no fat would be storing fat in her marrow,” says Gordon, director of the Bone Health Program. “Bone formation is very low in girls with anorexia, and that’s a particular problem because they are growing adolescents who should be maximally forming bones,” says Gordon.

She’s currently planning follow-up studies to find out why this happens. One speculation is that it’s the body’s attempt to store energy and preserve warmth. Anorexics often develop hypothermia because of a lack of insulating fat, and are often hospitalized with extremely low body temperatures.

February 21 to 27 is Eating Disorder Awareness Week. Although the media often portrays eating disorders as a modern phenomenon, they’ve actually been around for centuries. “Medical history documents anorexia as far back as the 1600s, when women took fasting to the extreme,” says Sara Forman, MD, director of the Eating Disorder Program. “But the question is, were they doing it for the same reasons as teens do now?” No one really knows what causes eating disorders like anorexia and bulimia, but many, including Forman, believe it’s a mix of genetics, culture and individual circumstance. “We talk about the gun being loaded biologically or genetically, and the trigger being pulled by society,” says Forman.

Read other Thrive posts about whether yoga can fight eating disorders and if unrealistic media images contribute to eating disorders.

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