Anorexia Loses When Period Returns

Anorexia patients had family therapy and weight gain brought back normal menstruation

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Dangerous weight loss as a result of an eating disorder can get in the way of a normal menstrual cycle. But when treatment works, girls gain weight and get their cycle back.

A recent study followed a group of girls with the eating disorder anorexia through one year of family-based therapy.

These results showed that girls who gained enough weight had their menstrual cycles return, which is a clinical sign of improvement with anorexia.

"Family therapy can help with anorexia."

Julianne Faust, BA, research assistant in Department of Psychiatry and Behavioral Neuroscience at the University of Chicago and Fulbright Research Fellow at the Hospital for Sick Children in Toronto, Canada, led a research project to investigate the return of reproductive health in girls with anorexia after family therapy.

Anorexia nervosa is a serious eating disorder. People with anorexia obsess about their weight and diet with the intention of reaching and maintaining an underweight status. Unhealthy levels of excessive exercise and starvation are symptoms of anorexia.

For many girls with anorexia, normal menstrual cycles stop due to weight loss. The return of normal menstrual cycles is an important clinical marker in improved health for anorexia patients, according to the study authors.

For the study, the researchers looked at 225 girls, between the ages of 11-20, who had participated in the University of Chicago Eating Disorders Program between 2001-2011.

In the program, the girls participated in around 20 outpatient treatment sessions with their families over the course of 12 months.

Girls who had never had a menstrual cycle, had a normal cycle or were taking contraceptives were excluded from the study.

After exclusions, 84 girls who were not experiencing normal menstrual cycles, but should have been, were included in the study.

The researchers used the Centers for Disease Control and Prevention (CDC) guidelines to determine what healthy weight status would be for each girl through body mass index (BMI) calculations.

For children and adolescents, BMI is calculated based on weight, height, age and gender. The CDC recommends that a 14 year old girl’s BMI should be no less than 15.5. At 16 years of age, a girl’s BMI should be no less than 16.75 and by 20 years of age, a girl’s BMI should be no less than 18.5.

At the start of the study, the girls averaged 82 percent of what their healthy body weights should have been.

After completing the family-based treatment sessions, the girls averaged 95 percent of what their healthy body weights should have been and 68 percent of the girls had normal menstrual cycles return.

The researchers said that the average weight gain required for each of the girls to have her menstrual cycle return was nearly 15 lbs.

The researchers found that the return of the menstrual cycle was associated with percentage of weight gained and had nothing to do with how underweight a girl was at the start of the study.

Girls who had their menstrual cycles return had an average BMI of 16.5.

The authors concluded that anorexia treatment weight gain goals should be to achieve at least 95 percent of the minimum recommended BMI score for the patient’s age.

This study was published in April in the Journal of Eating Disorders. The National Institutes of Health supported funding for this project. No conflicts of interest were found.

Reviewed by: 
Review Date: 
April 9, 2013
Last Updated:
January 23, 2014