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Bone Density Results May Influence Adolescents With Anorexia: Presented at ICED

BOSTON, MA -- April 25, 2002 -- Physicians have long recognized that early and severe osteoporosis is a serious consequence of anorexia nervosa. With this in mind, researchers at Children's Hospital Boston developed a study to determine if having a bone measurement to screen for low bone density changes the attitude and behavior of young women with anorexia nervosa.

While examining normal and low bone density results, researchers found the results to be interpreted both positively and negatively by participants depending on what stage of illness, from diagnosis to recovery, they were in. Those closer to recovery reported bone density results further motivated their recovery.

An abstract detailing these findings will be presented at the 2002 International Conference on Eating Disorders, April 25-28, in Boston, by Nava Stoffman, M.D., clinical fellow in the Department of Adolescent Medicine, and colleagues at Children's Hospital Boston.

Four focus groups were conducted with 12 young women (age 16 to 24) who had a diagnosis of anorexia nervosa and had bone density measurements performed during the previous year. Areas addressed included: bone health; the experience of having a bone scan performed; reaction to the results; and changes in the course of their illness. Of those, nine out of 12 had abnormal results. Ten of the participants stated that having a bone measurement did not enhance their recovery process at the time performed, but three of these 10 noted it motivated recovery later in their course.

Among the two remaining participants, one said the results were a driving force in her recovery, and one participant did not respond. Those who reported no effect stated that they were so "stuck in their eating disorder" or "in a fog" that they did not care about the results. They distorted their bone density results the same way they distorted their body image. Unhealthy reactions to getting results of a low bone scan included "there's something rewarding about how far you can push yourself," and the thought by some participants that low bone density results were positive because they would "weigh less."

"Timing of the bone measurement in relation to their phase of illness seemed to be a reoccurring factor in our results," said Dr. Stoffman. "In the beginning or middle of the illness, patients described themselves as too 'involved to change.' Later in the course, some became more aware and concerned about their bone scan results."

This is the first study that attempts to describe the influence of a bone measurement experience in young women with anorexia nervosa, explains Dr. Stoffman. Dr. Stoffman encourages health care providers to consider these responses and the stages of illness and recovery when informing patients with anorexia nervosa of bone scan results.

Other investigators of this study include: Estherann Grace, MD, associate in medicine, Beth Schwartz, research assistant, Catherine M.Gordon, MD, MSc, assistant in medicine, all at Children's Hospital Boston in the Department of Adolescent Medicine.

SOURCE: Children's Hospital Boston

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