There’s a very tidy relationship between what we eat and our bones. And often, it’s the one key relationship we don’t think about. Being aware of what your body needs to be healthy is important – and there is a host of information at your fingertips at any given time. In general we know what will make us strong, fit and healthy. But every now and then, we lose the plot.

We use food to diet ourselves down to sometimes unwarranted levels of thinness, or we become fearful of eating for some reason, or a range of psychological conditions cause us to view food in a way that becomes directly detrimental to our wellbeing. And while we might be worrying about our weight, our looks, and our digestive system, we are rarely considering the effects on our bones.

While we tussle with all this undereating, overeating, binge eating – along with low self-esteem or unresolved childhood experiences – our bones are suffering. Do eating disorders affect our bones? The short answer to that is yes, very much so. When there’s a lack of nourishment our bodies weaken, and no more so than our bones which are always on the lookout for some good, old-fashioned doses of calcium, magnesium and Vitamin D.

Even without the trauma of strange diets, osteoporosis can cause silent disruption to the building of bones. Let’s look at the fact sheet:

  • Osteoporosis is a disease that affects both women and men.
  • The disease causes bones to thin and weaken, and thus become more susceptible to fractures. The most common bones that break as a result of osteoporosis are in the spine, wrist, and hip.
  • Bone mineral mass increases during childhood and adolescence, and near peak bone mass is reached by about age 18-25. A smaller amount is produced until about age 30; after this, we lose about 1% of our bone mass per year.
  • Throughout our lives, there is a dynamic balance between bone formation and bone resorption. This balance can be affected by several factors, including lack of adequate nutrition and hormonal influences.
  • While bone loss can occur at any age, it certainly can accelerate with excessive weight loss (as in anorexia nervosa).

Osteoporosis and Eating Disorders

Anorexia nervosa: It’s disturbing to note that around half of young female patients with anorexia nervosa can develop osteoporosis. It is also worrying that even those who recover from this disease, up to 85%, will still prove bone mineral deficiencies, even if they have regained their periods and are within 10% of their ideal body weight. Also, not only women with anorexia nervosa develop osteoporosis, but men with anorexia nervosa are also at risk.

Bulimia nervosa: This is a particularly virulent eating disorder which prevents the body from receiving the right doses of nutriment. Sufferers are also at risk of osteoporosis, especially if they have had anorexia nervosa in the past, episodes of amenorrhea or significant weight loss.

Amenorrhea: Female athletes are particularly likely to create this condition through restrictive dieting and over-exercise. Those who have amenorrhea are at increased risk of developing bone loss.

What is the relationship between eating disorders and bone health?

  • If you have a bad diet when you’re young, or you develop any eating disorder, the effects can be harmful to your bones. Bones need to grow strong at young ages to last through your life, and if they are weakened at an early stage, the longer the damage will last, and the greater the risk of osteoporosis.
  • Good nutrition is critical. It’s what our bodies require. Don’t sacrifice your future health by trying to change your body shape when you are young. Don’t deprive yourself of the vital nutrients your body needs for strong bones: protein, calcium, and Vitamin D.
  • Poor nutrition, excessive exercise, and/or purging (such as by vomiting or laxative abuse) can cause an unhealthy, low body weight. And your bones need weight to operate efficiently. Drastic weight loss leads to bone loss and potential loss of muscle that supports and strengthens your bones.
  • Eating disorders can cause changes in hormone levels that are necessary to build and maintain strong bones. This is particularly important in women. Absence of regular menstrual periods may get in the way of bone building, speed up bone loss, and increase the risk of osteoporosis.

Can recovery from an eating disorder bring relief to your bones?

The short answer to this, is yes. Early recognition of an eating disorder might be missed – but it is vital to making an accurate diagnosis and get the necessary treatment underway as soon as possible. Getting back to a more nutritious diet and weight level are key to not only suppressing the illness but also the best way to prevent further bone loss and reduce your risk of osteoporosis.

  • You would have to be sure to eat a varied, nutrient-rich diet that provides the recommended amount of calories, protein, and other nutrients. A certified dietitian/nutritionist can help to find the eating plan that will work best for you.
  • Calcium remains very important in getting back the balance you need to counteract the detrimental effect of a diet disorder on your bones. Try to consume calcium-rich food at each meal or snack, or be sure to take a good supplement.
  • Vitamin D is an easy aspect of the progress to a healthier disposition for your bones. Just get out in sunlight as much as you can – 20 minutes a day is the usual yardstick with sunlight on the skin. Vitamin D in this way helps calcium to build and maintain stronger bones.
  • When your weight is restored, moderate physical activity can help build bone particularly while you are young. This helps to maintain bone strength as you age, along with muscle strength, posture and better balance.
  • Do not smoke – that’s a simple resolution. And limit your intake of alcohol at all ages. Smoking and drinking are harmful to your bones.

Love your bones! Eat well, sleep well, and do well by your bones.

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

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