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The purpose of this study was to evaluate the clinical utility of existing cut\u2010offs and severity criteria by determining which are most strongly associated with risk for low bone mineral density (BMD). Height adjusted BMD <jats:italic>Z<\/jats:italic> scores were calculated for 352 females: 262 with AN and 90 healthy controls (controls) (12\u201320.5 years), using data from the BMD in Childhood Study, for the lumbar spine, whole body less head, and total hip. For most cut\u2010offs used to define low weight (5th or 10th BMI percentile, BMI of 17.5 or 18.5, and 85 or 90% of median BMI), AN had lower BMD <jats:italic>Z<\/jats:italic> scores than controls. AN at &gt;85 or &gt;90% expected body weight for height (EBW\u2010Ht) did not differ in BMD <jats:italic>Z<\/jats:italic> scores from controls, but differed significantly from AN at \u226485 or \u226490% EBW\u2010Ht. Among AN, any amenorrhea was associated with lower BMD. AN had lower BMD than controls across DSM\u20105 and The Society for Adolescent Health and Medicine (SAHM) severity categories. The SAHM moderate severity classification was differentiated from the mildly malnourished classification by lower BMD at hip and spine sites. Amenorrhea and %EBW\u2010Ht\u2009\u2264\u200985 or\u2009\u2264\u200990% are markers of severity of bone loss within AN. Among severity categories, BMI <jats:italic>Z<\/jats:italic> scores (SAHM) may have the greatest utility in assessing the degree of malnutrition in adolescent girls that corresponds to lower BMD.<\/jats:p>","DOI":"10.1002\/eat.22681","type":"journal-article","created":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T16:05:28Z","timestamp":1486051528000},"page":"359-369","source":"Crossref","is-referenced-by-count":27,"title":["Impact of low\u2010weight severity and menstrual status on bone in adolescent girls with anorexia nervosa"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9745-4989","authenticated-orcid":false,"given":"Nurgun","family":"Kandemir","sequence":"first","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendra","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Slattery","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Tulsiani","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibha","family":"Singhal","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2601-581X","authenticated-orcid":false,"given":"Jennifer J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Coniglio","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Lee","sequence":"additional","affiliation":[{"name":"MGH Biostatistics Center, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamryn T.","family":"Eddy","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Klibanski","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhusmita","family":"Misra","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,2,2]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Diagnostic and statistical manual of mental disorders: DSM\u2010IV\u2010TR","author":"American Psychiatric Association","year":"2000"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31815cd9cf"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22248"},{"key":"e_1_2_6_6_1","unstructured":"First M. 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