Table 2.

Effect of weight optimization on bone mineral density measures

Weight recovery in anorexia nervosa
Follow-up	Age at onset of AN	Bone mineral density outcomes	Mean BMD and SD	Ref.
1 y	16.0±3.1 y	No significant changes at the lumbar spine compared with baseline measurements	Not available	[55]
3.6 y	17.8±3.7 y	Significant increase at lumbar spine (P<0.01) compared with former AN patients with persistently low BMI	Lumbar spine T-score: 1.14±0.13 vs 0.93±0.13	[52]
4 y	16 y	15.8 y after onset of AN, 8 of 11 women still met criteria for low BMD despite recovery	Total body T-score: −1.3 at baseline −1.01 at follow-up Lumbar spine T-score: −0.94 at baseline −0.62 at follow-up Hip T-score: −1.38 at baseline −1.32 at follow-up	[54]
8 y	15.0±1.9 y	Significant increase at hip (P<0.001) and spine ( P<0.01) compared with former AN patients with persistently low BMI	Hip Z-score: −0.02±1.11 vs −0.97±0.91 Spine Z-score: −0.62±1.31 vs −1.41±1.10	[53]
Weight loss in obesity
Follow-up	Age at weight loss	Bone mineral density outcomes	BMD changes	Ref.
12 mo	14.5±1.1 y	Whole body BMD did not change significantly from baseline in children who underwent an intensive weight loss trial	Whole body BMC: 1.08±0.67 at baseline 1.06±0.67 at follow-up	[59]
9 mo	51±8 y	Compared with baseline, adults who underwent bariatric surgery had significant decreases in their lumbar spine, femoral neck, total hip, trochanter, and total body BMD	Lumbar spine: −3.3 %±2.6 % Femoral neck: −5.1 %±7.1 % Total hip: −7.8 %±4.8 % Trochanter: −9.3±7.5 % Total body: −1.6±2.0 %	[60]
2 y	17.3±1.9 y	Whole body BMC and BMD Z-score decreased significantly (P<0.001) in adolescents who underwent bariatric surgery	Whole body Z-score: 1.5 at baseline 0.1 at follow-up Whole body BMC: −7.4 %	[61]

AN anorexia nervosa, BMC bone mineral content, BMD bone mineral density, BMI body mass index.