Fractures in patients with anorexia nervosa, bulimia nervosa, and other eating disorders--a nationwide register study

Int J Eat Disord. 2002 Nov;32(3):301-8. doi: 10.1002/eat.10101.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anorexia Nervosa / epidemiology*
  • Bulimia / epidemiology*
  • Cohort Studies
  • Female
  • Fractures, Bone / epidemiology*
  • Humans
  • Male
  • Random Allocation
  • Registries*