My STEAM project covers the objective “explain how bone development is hormonally regulated,” specifically how anorexia nervosa (AN) (eating disorder defined as a severe fear of weight gain) affects the development of osteoporosis. In a regular bone, osteoblast activity out way osteoclasts. When someone has osteoporosis on the other hand, the osteoclast cells out way the osteoblast cells, causing the breakdown of the bone to overrule the formation of new bone. 
There are multiple causes of osteoporosis but for this project I am focusing on how hormonal imbalances influence the development of the disease. Women are four times more likely to develop osteoporosis than men, which is partly due to hormonal imbalances. The hormones cortisol, oxytocin, parathyroid hormone (PTH), and especially estrogen cause a decrease in bone formation, less osteoblast activity, and increased osteoclast activity if there are imbalances, and one side effect of AN is hormonal imbalances, especially estrogen. Typically, a woman reaches her peak bone mass around the age of thirty. After she reaches that peak bone mass, she will begin to lose bone mass faster than she can develop new bone. After menopause, this process happens even faster, and if she has osteoporosis it will happen even faster than that. There are factors that can alter this process, including AN. Estrogen along with cortisol, oxytocin, and PTH are linked to bone health for women because they stimulate osteoblast activity along with the inhibitory effects on osteoclasts, so when someone has an imbalance, major problems may arise. A large portion of peak bone mass is achieved during puberty, so when a woman suffers from AN as an adolescent, she is at a higher risk of osteoporosis in later years. This is because the eating disorder causes someone to not be able to meet the peak bone mass around the age of thirty like an average person would. They will struggle with bone deficiency their whole life time because they will never reach a peak bone mass, which may cause osteoporosis. 
The media that I used to show how AN may cause osteoporosis is a digital drawing. I have drawn three different bones, one representing a healthy bone at a younger age (pre-menopausal), one representing a bone with AN, and one that shows a post-menopausal bone with osteoporosis. I also show a closer look at each bone. With the healthy bone, there are not many “holes” (the brown dots I put) within the bone’s honeycomb. With the osteoporosis bone, there appears to be more “holes” than actual bone. Finally, the bone that has AN appears to be in between the other two. 


Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrinol Metab. 2012 Nov;23(11):576-81. doi: 10.1016/j.tem.2012.03.008. Epub 2012 May 16. PMID: 22595550; PMCID: PMC3424385.

Hung, C., Munoz, M., & Shibli-Rahhal, A. (2021, March 5). Anorexia nervosa and osteoporosis – calcified tissue international. SpringerLink. Retrieved November 22, 2022, from https://link.springer.com/article/10.1007/s00223-021-00826-3

Osteoporosis: Symptoms, causes, tests & treatment. Cleveland Clinic. (n.d.). Retrieved November 22, 2022, from https://my.clevelandclinic.org/health/diseases/4443-osteoporosis  

Weaver, L., Liebman, R. Assessment of Anorexia Nervosa in Children and Adolescents. Curr Psychiatry Rep 13, 93–98 (2011). https://doi.org/10.1007/s11920-010-0174-y

3 Comments

  1. I find this post interesting. I did a project on diagnosing osteoporosis and there are two types of osteoporosis that you can be diagnosed with. Type I is caused by a lack of estrogen, and type II is essentially caused by a lack of calcium and activated hormones that trigger bone loss. If an anorexic woman were to be diagnosed with osteoporosis, which type would it be? As you’ve said anorexia nervosa affects the production of hormones like estrogen, which cause the body to make fewer osteoclasts and there is also an increase in the production of cortisol which causes bone loss, and the likely chance of calcium deficiency. This shows that diseases like osteoporosis aren’t all that strict in types and categories, they only serve as ways to understand osteoporosis. Insufficient peak bone mass caused by anorexia is also a good point Osteoporosis is likely to affect a person in their later years, so If a person with anorexia has already begun to lose bone at an earlier age, it may accelerate the process or increase the likelihood of osteoporosis. Osteoporosis also increases the chances of disabling fractures, especially true if the fracture is on the femur. So in the spirit of accounting for things beyond types, I wonder how a disability caused by osteoporosis would affect someone with anorexia’s mental health. Another thing is the cost of osteoporosis, it tends to be costly due to the disease manifesting as a fracture first. This is a situation where only treating one or the other will still result in persisting problems in the future. It would be beneficial and ideal to treat both anorexia and osteoporosis at the same time.

    Jox Iway
  2. Emma choose to do her project on “The effects that Anorexia has on Osteoporosis”. This project specifically aimed to cover the objective of “explaining how bone development is hormonally regulated”. With this objective in mind she specifically sought to show how anorexia nervosa affects the development of osteoporosis. There are multiple causes of osteoporosis but Emma choose to focus on how hormonal imbalances influence the development of the disease. The media she used to show her findings is a digital painting of three bones. The first displays healthy bone, the second shows bones afflicted with anorexia, and the third shows older bone. The media perfectly fits the research and findings that Emma covered in her brief summery of her project. Her project, I would also say, addresses the objective she wanted to cover perfectly.

    Max Beiergrohslein
  3. This project was extremely interesting to me. It was clearly stated the effects that Anorexia has on the development of our bones. The picture was clearly drawn out and showed the audience in a simple way, the differences in bone structure based on different levels of hormonal balances. She looked directly at how Osteoporosis can be caused due to the presence of Anorexia. This is directly linked to the balance of hormones, especially in females. Emma clearly explained the ways in which Osteoporosis deteriorates our bone density. She was clear in her explanation of how this process works, however she was able to use language that was easy to understand, meaning you did not need to have prior knowledge on any of these issues, due to the fact that she clearly explained the processes as well as the different terms she used in her explanation. She used the pictures of three different bones to show us how they differ based on age, as well as hormonal balance. We could clearly see from the image, the message she was trying to convey. It was a simple and easy way for the audience to gain a general understanding of the topic she later went into greater depth on. She was clear in the way that hormones affected the decay of our bones. However I wish there was a little more information on the ways that Anorexia impacts osteoporosis. I felt as though this was the main point of the topic, it could have used a little more emphasis on the science behind the ways in which Anorexia affects bone density. However, there was still significant supporting evidence.

    kennedy

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