# Differences in Spinal Posture and Movement Between Adult Females with Anorexia Nervosa and Age- and Sex-Matched Normal-Weight Controls

## TL;DR

This study finds that adult females with anorexia nervosa have reduced spinal curvatures and increased thoracic flexion compared to normal-weight controls, suggesting the need for musculoskeletal assessments in treatment.

## Contribution

The study provides new empirical evidence on spinal posture and mobility differences in anorexia nervosa patients compared to controls.

## Key findings

- Anorexia nervosa patients showed reduced lumbar and thoracic curvatures compared to controls.
- Thoracic flexion was greater in individuals with anorexia nervosa.
- Spinal posture and mobility differences suggest the need for targeted interventions in anorexia nervosa.

## Abstract

Background: Anorexia nervosa is an eating disorder characterised by distorted eating behaviour, physical and mental health problems, and the highest mortality rate among psychiatric disorders. Although anorexia nervosa appears to be associated with alterations in the spine, studies investigating the characteristics of spinal postures and mobility in individuals with anorexia nervosa are scarce to date. The present study aims to examine the relationship between anorexia nervosa and spinal posture and mobility by comparing people with anorexia nervosa to age-matched, normal-weight controls. Methods: Spinal posture and mobility were evaluated using a radiation-free back scan, the Idiag M360 (Idiag, Fehraltorf, Switzerland). Between-group differences were assessed using a two-way analysis of variance. Results: Adult females suffering from anorexia nervosa exhibited reduced lumbar [difference between groups (Δ) = 10.5°, 95% CI 4.6°–16.5°, p < 0.001] and thoracic (Δ = 8.8°, 95% CI 2.4°–15.2°, p = 0.007) curvatures compared to normal-weight controls. The only difference observed in spinal movements between the two groups was thoracic flexion, which was greater in individuals with anorexia nervosa (Δ = 8.4°, 95% CI 2.1°–14.4°, p = 0.009). Conclusions: These findings emphasise the need to consider spinal posture and thoracic mobility in the musculoskeletal assessment of anorexia nervosa. Interventions aimed at improving spinal postures may help to develop effective rehabilitative strategies for addressing spinal problems associated with anorexia nervosa and thus contributing to counteract the possible further worsening with advancing age.