We hear a great deal about overeating and obesity, but dieting to stay slim may also cause problems. The image of the anorexic model may seem extreme but long before this point is reached serious health issues may develop. The potential actress, ballet dancer, model, gymnast or athlete may be in the early stages of osteoporosis and broken bones.

Bone is a living tissue which develops during childhood, adolescence and early adulthood. Calcium and other nutrients from the diet are added to the developing bones, strengthening the skeleton.
The structure of bone is like a solid sponge, with strands of bone surrounding small holes. As a person gets older, some loss of bone mass is normal. As bone tissue is lost, these strands become thinner and excessive loss leaves large gaps in the bone. This causes the bones to become weak, brittle and to break easily, the medical term for which is osteoporosis. This is usually considered a condition of the elderly, with fractures after minor falls and bent spines. Unfortunately, because of the subtle balance between hormones, diet and body structure, it is an increasing problem in teenage girls.
In the young, osteoporosis refers to premature bone loss or inadequate bone formation leading to fragile bones and potential fractures.
At the 40th Annual American College of Sports Medicine Meeting in 1993, the name Female Athlete Triad was given to a combination of symptoms - amenorrhea, disordered eating, and osteoporosis. It was noted that observations about bone mineral densities, eating disorders, and female athletics were described for decades before this name was given.
Stress fractures are a major concern of athletes and their trainers, particularly in the USA with increasing numbers of professional women athletes and the financial implications of injury. In many cases these are due to osteoporosis. For some, the full impact of this syndrome may not be realized until these women reach menopause, when bone loss is accelerated.
Amenorrhea usually refers to secondary amenorrhea (cessation of periods), although primary amenorrhea, (delayed first period or menarche) can occur in dieting teenagers.
The range of disordered eating includes anorexia nervosa, bulimia, use of diet pills, laxatives; a preoccupation with eating; fad diets and a fear of becoming fat.
The Female Athlete Triad, referred to as F.A.T. is a very bad choice of acronym to label patients who have a morbid fear of weight gain and implies that this only occurs in athletes.

The prevalence of disordered eating in the female athletic population has been estimated to be as high as 62%, with the incidence of anorexia nervosa and bulimia estimated at up to 39%.
Although all young dieters are at risk diagnosis is often missed because of the secretive nature of the disease. Similar to individuals with anorexia or bulimia, many will try to hide their symptoms or behaviour from friends, family, teachers and trainers. In fact, the vast majority of cases are diagnosed only after advanced symptoms become apparent.

Those who wish to lose weight, or maintain a low body weight, do not simply eat smaller portions of food. They change their diet altering the balance of nutrients, often taking some to excess.

Teenage girls and young women with a history of dieting and irregular periods should have a medical assessment.