Imaging studies are not routinely required for the diagnosis of anorexia nervosa. When performed, imaging is used primarily to evaluate complications of chronic undernutrition or to exclude alternative medical causes of weight loss, rather than to confirm the diagnosis itself.^[1][2]

• Dual-energy X-ray absorptiometry (DEXA) is the primary imaging modality used in anorexia nervosa
• Common findings include:
  • Decreased bone mineral density
  • Osteopenia or osteoporosis
• Bone loss is associated with increased fracture risk and may persist despite weight restoration.^[3][2][4]

Practice guidelines recommend bone density assessment in individuals with prolonged amenorrhea or other risk factors for skeletal fragility.^[2][4]

• No characteristic findings on CT, MRI, or ultrasound are specific to anorexia nervosa
• These studies may be performed selectively to:
  • Exclude gastrointestinal disease
  • Evaluate unexplained symptoms
  • Assess complications unrelated to the eating disorder itself^[1]

Aside from bone density assessment, there are no routine or diagnostic imaging findings specific to anorexia nervosa. Imaging should be guided by clinical context and used to evaluate complications or alternative diagnoses rather than as a primary diagnostic tool.