Teriparatide treatment of osteoporosis in a patient with anorexia nervosa

Osteoporosis commonly occurs in patients with anorexia nervosa (AN) and is often irreversible even after weight restoration. We describe a 52-year-old woman with AN and severe osteoporosis, discovered after she sustained multiple fractures from a fall. She had low weight for most of her life, but was only formally diagnosed with AN 6 years prior to her presentation. She received therapy for her eating disorder and was able to restore weight, which led to a 4.1 % improvement in her bone density. We then treated her with teriparatide for 2 years, which lead to a further 21 % increase in bone density and she has had no recurrence of fractures. Since AN-associated osteoporosis is characterized by low bone formation, teriparatide may be a useful treatment option.