The Long Term Biological Consequences of Anorexia Nervosa

The long-term psychiatric and psychological outcome of the anorexia nervosa (AN) has been well described. Less is known about the long-term physiological effects of the illness and this article reviews the findings to date. Having a history of AN does not appear to increase the risk of infertility, but may increase the risk of birth complications and of having a low birth weight infant. Although evidence on the reversibility of bone mineral density loss in AN is conflicting, osteoporosis-related fracture rates are higher in women with previous AN. Animal models of energy restriction and two studies in AN suggest that AN may confer protection against breast cancer, however data are preliminary. Furthermore, it is theoretically possible, that deficiencies of chemoprotective nutrients, chronic constipation, laxative abuse, and selfinduced vomiting may increase the risk of other, and in particular, gastrointestinal tract, pathology. This risk remains to be investigated. The metabolic and endocrine effects of the illness are largely reversed with recovery, but various disturbances in pancreatic hormone secretion have been described and require further clarification. As cohorts of women with a history of AN mature, well controlled studies are recommended to provide further information on the long-term health consequences of AN.