{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:38:35Z","timestamp":1773920315279,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Anorexia nervosa (AN) is a complex eating disorder characterized by self-induced weight loss, distorted body image, and profound endocrine dysregulation. In adolescents, the illness leads to growth failure, pubertal delay, amenorrhea, and compromised bone mineral accrual. This mini review synthesizes current evidence regarding the pathophysiology and management of endocrine disturbances in adolescents with AN, with a particular focus on therapeutic strategies for growth failure, pubertal arrest, and reduced bone mineral density. Endocrine abnormalities in AN involve adaptive suppression of the hypothalamic\u2013pituitary\u2013gonadal, \u2013adrenal, \u2013thyroid, and \u2013growth hormone axes. Nutritional rehabilitation remains the cornerstone of recovery, as restoration of energy balance normalizes gonadotropin secretion, promotes catch-up growth, and improves bone accrual. Among hormonal options, physiologic transdermal estrogen is currently the only evidence-based strategy for improving bone density and supporting reproductive recovery. Adjunctive therapies such as rhGH, rhIGF-1 or DHEA may hold potential in specific subgroups but require further validation through larger, age-specific randomized trials.<\/jats:p>","DOI":"10.3389\/fped.2026.1765684","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:51:19Z","timestamp":1773903079000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic approaches for endocrine dysregulation in anorexia nervosa in adolescents"],"prefix":"10.3389","volume":"14","author":[{"given":"Lotte","family":"Hoskens","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University Hospitals Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieve","family":"Sevenants","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaux","family":"Van Insberghe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Casteels","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Leuven","place":["Leuven, Belgium"]},{"name":"Department of Development and Regeneration, KU Leuven","place":["Leuven, Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"B1","volume-title":"Epidemiology of Eating Disorders: An Update","author":"Keski-Rahkonen","year":"2018"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.4158\/EP.14.8.1055","article-title":"The endocrinopathies of anorexia nervosa","volume":"14","author":"Usdan","year":"2008","journal-title":"Endocr Pract"},{"key":"B3","doi-asserted-by":"publisher","first-page":"5512532","DOI":"10.1155\/2021\/5512532","article-title":"Arrested puberty in an adolescent male with anorexia nervosa successfully resumed with multidisciplinary care","volume":"2021","author":"Sim\u00e3o Raimundo","year":"2021","journal-title":"Case Rep Pediatr"},{"key":"B4","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.jadohealth.2014.11.020","article-title":"Update on the medical management of eating disorders in adolescents","volume":"56","author":"Golden","year":"2015","journal-title":"J Adolesc Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1210\/clinem\/dgab145","article-title":"Effect of transdermal estradiol and insulin-like growth factor-1 on bone endpoints of young women with anorexia Nervosa","volume":"106","author":"Singhal","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","first-page":"4347","DOI":"10.1210\/jc.2019-00828","article-title":"A randomized placebo-controlled trial of low-dose testosterone therapy in women with anorexia Nervosa","volume":"104","author":"Kimball","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1038\/nrendo.2016.175","article-title":"The endocrine manifestations of anorexia nervosa: mechanisms and management","volume":"13","author":"Schorr","year":"2017","journal-title":"Nat Rev Endocrinol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1542\/peds.2004-0540","article-title":"Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls","volume":"114","author":"Misra","year":"2004","journal-title":"Pediatrics"},{"key":"B9","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1097\/MED.0000000000000026","article-title":"Endocrinology of anorexia nervosa in young people: recent insights","volume":"21","author":"Singhal","year":"2014","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B10","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1530\/EC-17-0200","article-title":"Can growth hormone treatment improve growth in children with severe growth failure due to anorexia nervosa? 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