Bone health – anorexia nervosa — RACP Paediatrics MCQ

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HardEndocrineBone health – anorexia nervosaRACP Paediatrics

A 15-year-old with anorexia nervosa has a DEXA Z-score of -2.8. She has secondary amenorrhoea for 2 years. Weight is 70% of ideal body weight. What is the most important intervention for her bone health?

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Correct answer: E — Weight-bearing exercise

Weight restoration and resumption of menses is the most important intervention for bone health in anorexia nervosa. Weight-bearing exercise (when medically safe) is beneficial. Bisphosphonates are NOT recommended in adolescents with eating disorders as they have not shown benefit and have teratogenic potential. Oestrogen replacement is controversial and does not substitute for weight restoration. Ensuring adequate calcium and vitamin D intake is important adjunctive care.

Reference: RCH Melbourne – 2023 – Eating Disorders CPG; RACP Paediatric Curriculum – Endocrine