Bone health in adult women with ED: A longitudinal community-based study

Lauren Robinson, Victoria Aldridge, Emma Clark, Madhusmita Misra, Nadia Micali

Research output: Contribution to journalArticle (Academic Journal)peer-review

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lthough Eating Disorders (ED) are known to affect bone health and development, little is known about the longitudinal effect of ED and ED behaviours on bone health in community dwelling adult women. Women (n = 3507) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) participated in a two-phase prevalence study to assess lifetime ED and ED behaviours (fasting, restrictive eating, vomiting and misuse of medication). Crude and adjusted linear regression methods investigated the association between ED diagnoses and behaviours, and total body, hip, leg and arm bone mineral density (BMD) DXA scans at mean ages of 48 and 52 years. Lifetime occurrence of Anorexia Nervosa (AN) was associated with lower BMD Z-scores for the whole body (mean difference (MD) = −0.28; 95% CI: -0.49, −0.05), hip (MD = −0.45; 95% CI -0.74, −0.16), leg (MD = −0.28; 95% CI -0.52, −0.03) and arm (MD = −0.44; 95% CI -0.68, −0.19) compared to no ED. This effect was mostly accounted for by lowest ever BMI. In post-hoc analyses, Restrictive AN, but not Binge-Purge AN was associated with a lower total body BMD Z-scores (MD = −0.37; 95% CI -0.62, −0.12). Lifetime Fasting and Restrictive Eating were associated with low BMD of the total body, hip, arm and leg in adjusted analyses, all p < 0.05. Both lifetime ED diagnoses and ED behaviours in a large community sample were predictive of low BMD in mid-life. This study confirms that the effects of AN, fasting and restrictive eating, and low BMI on bone health seen in clinical samples also occur in community samples.
Original languageEnglish
Number of pages8
JournalJournal of Psychosomatic Research
Early online date17 Dec 2018
Publication statusE-pub ahead of print - 17 Dec 2018


  • Women
  • Eating Disorders
  • Anorecia Nervosa
  • Bulimia Nervosa
  • Osteoporosis
  • Bone Mineral Density


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