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Medicine Grand Rounds - Endocrine Complications of Anorexia Nervosa

Dr. Haines discusses endocrine changes that are observed in anorexia nervosa which are adaptive to the state of chronic starvation and may contribute to impaired skeletal integrity and neuropsychiatric symptoms. Weight restoration and menses recovery are critical to improving skeletal health, but low bone density and increased fracture risk may remain long-term complications for adults in recovery from anorexia nervosa, especially if peak bone density was not reached. There are several potential pharmacologic strategies for low bone mineral density currently under clinical investigation, but a conservative approach without medication can be effective.

Activity Details

Start Date:  July 31, 2020
End Date:  July 31, 2023

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Learning Outcome

Participants will be able to discuss the endocrine abnormalities in anorexia nervosa and how they contribute to impaired skeletal integrity and neuropsychiatric symptoms, and to summarize potential therapeutic strategies for low bone mineral density that are currently under clinical investigation.

  • Melanie Schorr Haines, MD
    Assistant Professor of Medicine, Harvard Medical School
    Assistant Physician, Massachusetts General Hospital
    About our presenter: 
    Dr. Melanie Schorr Haines graduated from Dartmouth College and received her MD from the Johns Hopkins University School of Medicine. She completed Internal Medicine Residency at the Brigham and Women’s Hospital and Endocrinology Fellowship at the Massachusetts General Hospital. She is an NIH-funded investigator with clinical research interests in the endocrine determinants of skeletal health across the weight spectrum, as well as muscle as a determinant of skeletal and metabolic health in adults with obesity. She maintains a clinical practice in the Neuroendocrine & Pituitary Tumor Clinical Center at the Massachusetts General Hospital.

Dartmouth-Hitchcock is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Dartmouth-Hitchcock designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Requirements for Successful Completion

In order to receive credit for this Continuing Medical Education (CME) activity, you must:

  • View the entire presentation
  • Complete the online Attestation of Attendance & Evaluation Form (you must register to access).

In accordance with the disclosure policy of Dartmouth-Hitchcock/Geisel School of Medicine at Dartmouth as well as standards set forth by the Accreditation Council on Continuing Medical Education and the Nursing Continuing Education Council standards set forth by the American Nurses Credentialing Center Commission on Accreditation, continuing medical education and nursing education activity director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have been asked to disclose any financial relationship* they have to a commercial interest (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on patients). Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide participants with information that might be of potential importance to their evaluation of a given activity.

The following Activity Physician Director(s), planning committee member(s), speaker(s), author(s) or anyone in a position to control the content have reported the following financial interest or relationship* with various companies/organizations. The Activity Director and Planning Committee member roles were resolved by altering the individual’s control over content about the products or services of the commercial interest by the Associate Dean for CME and the Department of Medicine Chair. All potential conflict(s) were resolved.

* Kelly Kieffer, MD ~ her spouse is a consultant for OcculoBio. 

* Richard I. Rothstein, MD ~ has research support from Baranova (research grant to Dartmouth-Hitchcock Medical Center) and is on the Scientific Advisory Board for Allurion.

Other planning committee member(s), speaker(s), activity director(s), author(s) or anyone in a position to control the content for this program report no financial interest or relationship* with any company(ies) or organizations whose product may be germane to the content of their presentations.

*A “financial interest or relationship" refers to an equity position, receipt of royalties, consultantship, funding by a research grant, receiving honoraria for educational services elsewhere, or to any other relationship to a company that provides sufficient reason for disclosure, in keeping with the spirit of the stated policy.

Bibliographic References
  • See presentation for bibliographic sources to allow for further study.

Provider Contact Information

Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
Dartmouth-Hitchcock Medical Center

Type:     Internet Activity (Enduring Material)
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