Anorexia nervosa (AN) is a mental health disorder whose features are deliberate weight loss, disordered body image, and intrusive overvalued fears of gaining weight. Long term consequences of AN include endocrine dysfunctions resulting in low levels of gonadotropins and estrogens, secondary amenorrhea, bone loss and/or osteoporosis. Bone reabsorption is related with the exposure to low levels of estrogens leading to an increased risk of bone fractures as it happens in late postmenopausal period and young women with AN may develop a risk for pathological fractures comparable to that of menopausal women.

In our case report series we examined the influence of AN related amenorrhea on bone mineral density (BMD).

We evaluated BMD with computerised bone mineralometry (CBM) in 10 women with diagnosis of AN, hospitalized in the Psychiatric Clinic of University of Pisa.

All the patients showed a lumbar and femoral bone loss or osteoporosis with an increased fracture risk in comparison with peers and comparable to that of menopausal women.

Our data support the hypothesis that lower estrogenic levels associated with AN have an impact on BMD. Although osteoporotic complications and fracture risk are underdiagnosed, underestimated and potential cause of permanent disability is a predictable and treatable condition in AN patients. Therefore we recommend a more accurate evaluation of BMD with CBM in all patients with prolonged amenorrhoea.