Anorexia, bulimia, and the athletic triad: evaluation and management.

Caloric restriction caused by undernutrition or over-exercise is increasingly common and has significant health consequences such as hypothalamic amenorrhea, infertility, attainment of low peak bone mass, and bone loss leading to fracture. In these patients, the pathophysiology of amenorrhea and bone loss is multifactorial, involving hormones that integrate the nutritional state with the hypothalamic-pituitary-ovarian axis, including leptin and possibly ghrelin. The pathophysiology of bone loss includes nutritional deficiencies, possibly estrogen deficiency, and direct and indirect effects of leptin on bone.

Leptin levels and luteinizing hormone pulsatility in normal cycling women and their relationship to daily changes in metabolic rate.

Objective: To determine whether leptin and LH secretion in normal women is related to changes in metabolic rate.

Setting: Academic medical center. PATIENT(S) AND DESIGN: Ten young women with normal weight and menses were studied during the early follicular phase.