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Keywords:

  • anorexia nervosa;
  • bulimia nervosa;
  • eating disorder;
  • fracture;
  • risk

Abstract

Objective

To study fracture risk in patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not otherwise specified (EDNOS).

Method

Cohort study including all Danes diagnosed with AN (n = 2,149), BN (n = 1,294), or EDNOS (n = 942) between 1977 and 1998. Each patient was compared with three randomly drawn age- and gender-matched control subjects.

Results

Fracture risk was increased in AN after diagnosis compared to controls (incidence rate ratio: 1.98, 95% CI: 1.60–2.44), but not before. The increased fracture risk persisted more than 10 years after diagnosis. A significant increase in fracture risk was found before diagnosis in BN (1.31, 95% CI: 1.04–1.64), with a trend towards an increase after diagnosis (1.44, 95% CI: 0.93–2.22). EDNOS patients had a significant increase in fracture risk before (1.39, 95% CI: 1.06–1.81) and after diagnosis (1.77, 95% CI: 1.25–2.51).

Discussion

The increased fracture risk many years after diagnosis indicates permanent skeletal damage. © 2002 by Wiley Periodicals, Inc. Int J Eat Disord 32: 301–308, 2002.