The carpal bones of 18 anorexia nervosa patients were radiographed and the X-ray age assessed by 2 different standard methods. The study demonstrates that skeletal development in anorexia nervosa patients is delayed such that there is no association between radiological assessment of age and chronological age. It is strongly suggested that bony development actually ceases when body weight falls sufficiently to stop menstruation. There was a highly significant (P = 0.001) linear relationship between radiological age and the sum of the age of onset of the illness plus any period(s) of re-feeding. Weight gain seems to re-kindle the bone maturing mechanisms: the role of weight thresholds and associated hormone activity being discussed. The findings of this study strongly support the existing evidence that the anorexia nervosa patient is biologically and psychologically immature.
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