Q & A: Short Stature from AN: Can Boys Catch Up?

Q. I’m treating an 11-year-old boy with anorexia nervosa (AN) who’s short in stature. He and his parents are concerned about his ultimate height and are asking about how much height he might expect to regain once he’s over the anorexia nervosa.  What might I advise them? (C.Y., Detroit)

A. It’s been known for some time that boys with AN lose ground with respect to height. The extent to which they might “catch up” following recovery has been unclear, and depends in part on the specific ages at which the illness has occurred, its severity, the nature and extent of nutritional rehabilitation, and when the syndrome finally remits. The specific stages and timing of the individual’s critical periods concerning bone growth all matter.  In a recent Swedish study in which 46 boys with AN who had not yet started their pubertal bone growth were followed for 1 to 3 years, the 13 boys who had not yet started their pubertal grown immediately caught up following nutritional rehabilitation, and after 3 years had returned to their premorbid growth curves. However, boys who had already started their pubertal growth spurt didn’t do as well. On average, the 33 boys in this group had lost 4.5 cm (1.8 in) of height (Eur Eat Disord Rev. 2013; 21:5:395-8). Consultation with your patient’s pediatrician, and perhaps a pediatric endocrinologist, might help clarify his specific situation.

— JY