Eating Disorder Awareness Week: Know your osteoporosis risk

To mark Eating Disorder Awareness Week, the Royal Osteoporosis Society (ROS) is sharing a striking personal account that highlights a critical lack of recognition, education and follow‑up care around osteoporosis - particularly for younger people whose bone health has been damaged by long‑term undereating. 

Kel, who developed an eating disorder at 18, was first sent for a precautionary bone density scan after several years of being significantly underweight. “I didn’t know what osteoporosis was at the time,” she says. “I didn’t expect the scan to show any issues, and neither did the psychiatrist. But I got an osteoporosis diagnosis straight away.” 

Despite the seriousness of the result, Kel says she received little explanation or ongoing support. She was advised to take calcium supplements and return in three years. Subsequent scans at 27 and 30 showed no improvement, yet she was again told only to “contact a doctor if you break anything”. 

“I felt I was being left alone to get on with it,” she says. “I remember my boyfriend at the time called the ROS Helpline when I was first diagnosed and they sent me information. I was scared to do anything in case I broke a bone. I now know that was a misunderstanding - but no one explained it to me until I found the ROS.” 

Her situation became even more complex after a hysterectomy at 29, which further increased her risk due to reduced oestrogen levels. Kel now takes medication for HRT (Hormone Replacement Therapy) and has requested annual scans to monitor her bone density more closely. 

“I can’t be the only person with osteoporosis at my age,” she says. “It concerns me that others may be getting the same lack of information I did. I would urge people in the same situation to reach out to the ROS.” 

Now working as an eating disorder therapist, Kel says the link between restrictive eating and bone damage is still not widely understood - even among healthcare professionals. She added, “There needs to be far greater awareness of osteoporosis and how we protect our bones from a young age. I had no idea I was contributing to something potentially irreversible.” 

Eating Disorder Awareness Week shines a spotlight on the long‑term health consequences of undereating. Low body weight is a key risk factor for osteoporosis, yet many people with restrictive eating patterns do not realise the damage until years later. 

Anorexia can cause osteoporosis and subsequent fractures because it can affect healthy bone growth and lead to low bone density, meaning bones may be weaker and more likely to break. There are several reasons for this: 

• Oestrogen levels may drop. Oestrogen is a hormone that’s important for healthy bones. 

• Insulin-like growth factor 1 (IGF-1) hormone may drop. IGF-1, a hormone related to growth hormone, is important for healthy bone growth during puberty, and for bone health in general. 

• Cortisol may increase. High levels of cortisol, a steroid hormone, can affect bone health. 

• Bones may not get the nutrition they need. 

• The size and strength of muscles may decrease. This means the bones experience less force from the muscles and may become weaker 

“Kel’s story reflects what many people experience - a slow slide into harmful patterns that feel normal at the time,” said Kirsty Carne, Specialist Osteoporosis Nurse at the Royal Osteoporosis Society. “This week is a crucial moment to highlight how these behaviours can affect bone strength and long‑term bone health. Early support can make a life‑changing difference.” 

The ROS is campaigning for better education, earlier diagnosis with a national roll-out of Fracture Liaison Services, and more consistent follow‑up care for anyone who may be vulnerable to osteoporosis, particularly those with high risk factors such as eating disorders. 

We've created a free, online 3-minute risk checker, the Great British Bone Check, backed by experts, to enable everyone to understand their risk of broken bones. Check your risk today.