Real story: “I was significantly underweight for over three years”

What we eat and drink plays a major part in our own bone health story. Getting the right nutrition is essential for strong and healthy bones. And if that nutrition is missing over a number of years – perhaps because of a medical condition like an eating disorder - low bone density can be the result, making bones weaker and more likely to break.

“I had an eating disorder when I was 18 years old, which was at its worst for around three years,” says Kel. “At the time I was accessing eating disorder services and I was told that because I was significantly underweight for over three years, I should be sent for a DXA scan as a precautionary check.

“I didn’t know what osteoporosis was at the time and I didn’t expect the scan to show any issues and neither did the psychiatrist. But I got a diagnosis of osteoporosis straight away.

“Because my weight had returned to an almost normal level by this time, it was assumed that my bone density would just improve by itself. They suggested I start taking a calcium supplement and that I would be reviewed in three years. This was when I was 24 years old.”

Lack of information

Three years passed and Kel was given another DXA scan.

“My results came back the same, so at that point I started taking a prescribed vitamin D supplement,” she explains. “I was told again I would be reviewed in three years, but nothing was properly explained - I was just told to contact my doctor if I broke anything. I felt that I was being left alone to get on with it.”

This lack of information spurred Kel to do her own research.

“I remember my boyfriend at the time called the ROS Helpline when I was first diagnosed and they sent me information about it. I was scared to do anything out of fear of breaking a bone, which I now know is a misunderstanding,” she says.

When Kel was 30, she had another DXA scan, and the results were again the same.

“I hadn’t broken any bones during this period but I still felt worried about what this would be like. I started to ask myself if I was going to live my life being scared forever.”

Another health blow

Then, in 2019, Kel had more health issues to contend with and underwent a total hysterectomy due to the pain of endometriosis.

“I was aware this increased my osteoporosis risk even more due to decreasing my levels of oestrogen (the female sex hormone that helps keep bones strong).  I discussed this risk with my gynaecologist but decided it was worth it to get rid of the pain I was experiencing.”

Kel is now taking HRT and has requested a DXA scan every year instead of every three to keep a closer eye on her bone density.

“I can’t be the only person with osteoporosis at my age and it concerns me that others may get the same treatment and information as I did from healthcare professionals,” she says.

“I now work as an eating disorder therapist. As a professional in the eating disorder field, it makes me think there should be a much greater awareness of osteoporosis and how we can protect our bone health from a young age. I didn’t have any concept that I was contributing to anything that was potentially irreversible."

Anorexia is a complex medical condition and it can take many years to recover. Your bone health will be at greater risk if you have severe or long-term anorexia. It’s important to get your eating disorder diagnosed and to start treatment for your anorexia as early as possible. This is the most important thing you can do for your overall health and wellbeing, including your bones.

Choosing the right foods

“When I was diagnosed with osteoporosis, I was still in the early days of recovering from my eating disorder, so it was pretty overwhelming to consider the changes I might need to make from a nutritional perspective. Meeting with a dietitian definitely helped,” explains Kel. “They helped me understand what my body needed and suggested simple, practical changes that fit into my stage of recovery and also within my lifestyle. Trying to overhaul everything at once isn’t realistic, so focusing on small, sustainable steps worked best for me.”

Now, having recovered from anorexia, Kel focuses on nourishing her body “without over thinking it”, as she says.

“I make sure to include foods that support my bones, like those rich in calcium and vitamin D, and I take supplements where needed - it’s an easy and effective way to fill any gaps,” she adds.

“For anyone else in a similar position, I’d say that nutrition is key, but it doesn’t have to be complicated or perfect. Getting support, from a dietitian or another professional, can make it feel more manageable, so don’t be afraid to ask for help or to ask as many questions as you need to.”

Protecting your bones

To learn more about how anorexia specifically affects your bone health, read our anorexia fact sheet. Or get more information about anorexia and other eating disorders from these organisations:

• Beat
• First Steps ED
• National Centre for Eating Disorders

Kel also offers counselling and training herself at The Eating Disorder Recovery Champion.

Calcium and vitamin D are essential for good bone health but other vitamins and minerals play a part too. Find out more about the nutrition we need for healthy bones here and find some delicious recipes that can help support your bone health on our blog.