Chronic undernutrition and negative energy balance are important but often underrecognized causes of bone loss and skeletal fragility. Many clinicians are familiar with osteoporosis related to aging or menopause but may have limited knowledge regarding the hormonal adaptations to undernutrition and their effects on bone metabolism. As emerging research continues to improve understanding of undernutrition-related bone disease and potential therapeutic approaches, there is a need to update clinicians on current evidence and best practices for evaluation and management.

The field has evolved significantly through advances in understanding the neuroendocrine response to nutritional stress and the mechanisms underlying bone loss in conditions such as anorexia nervosa and chronic energy deficiency. Many practicing clinicians completed training before much of this evidence became available and may not be aware of emerging therapeutic strategies. This activity will address knowledge and competence gaps by providing an evidence-based review from a nationally recognized expert in undernutrition and bone health.