EFFECTS OF WEIGHT-GAIN AND RESUMPTION OF MENSES ON REDUCED BONE-DENSITY IN PATIENTS WITH ANOREXIA-NERVOSA

The bone mineral density (BMD) of the lumbar vertebrae (L2-L4) and of the whole body were measured in cross-sectional and longitudinal studi es in female patients with earing disorders, using dual photon absorpt iometry before and after weight gain with or without resumption of men ses. In the cross-sectional study, the low-body-weight anorectic patie nts, with or without bulimia nervosa, were found to have lower BMD of the lumbar vertebrae associated with severe weight loss, low physical activity, and earlier onset and longer duration of amenorrhea. In the longitudinal study, 11 patients attained subnormal body weight (70%SBW less than or equal to similar to < 85% SBW), 10 patients attained nor mal body weight (greater than or equal to 85%SBW, 6 patients of them r esumed regular menses) after treatment. The BMD of the lumbar vertebra e was found to increase with weight gain, bus not to the control level . The BMD was further increased with the resumption of menses in patie nts with anorexia nervosa. These results suggest that resumption of me nses, in addition to weight gain, is essential to normalize reduced bo ne mineral density.