Cardiovascular complications contribute to higher morbidity and mortality in patients with anorexia nervosa (AN). We aimed to study biomarkers of cardiovascular risk in anorexic, normal-weight, and obese adolescents with focus on complex cardiovascular autonomic regulation and early arteriosclerotic damage. We examined 20 adolescent girls with AN, 20 obese girls, and 20 healthy normal-weight controls. Collected data: body composition analysis, 5 min recordings of RR-intervals and beat-to-beat blood pressure (BP), arterial stiffness index cardio-ankle vascular index (CAVI). Evaluated parameters: beat-to-beat heart rate and BP variability, hemodynamic parameters (total peripheral resistance – TPR, cardiac output), CAVI, anthropometric indices including novel body roundness index (BRI). Adolescents with AN had increased CAVI associated with lower arterial constriction indexed by low-frequency band of BP variability (LnLF-BPV) compared to normal-weight peers (p=0.03, p=0.04, respectively) and obese adolescents (p<0.01, p=0.01, respectively). After normalization of CAVI and TPR by BRI, the relationship between CAVI and TPR was significant for all groups with the highest slope in AN group (R2=0.724, p<0.01). This is the first study revealing early arteriosclerotic damage in anorexic girls with increased CAVI. Complex analysis of cardiovascular autonomic regulation, early arteriosclerotic, hemodynamic and anthropometric changes in spectrum anorexia nervosa – normal weight – obesity could help to understand the mechanisms of increased cardiovascular risk in malnutrition. Novelty: • Anorexic girls showed signs of early arteriosclerotic damage indexed by CAVI • Insufficient sympathetic cardiovascular control was found already in anorexic adolescents • The effect of body composition on CAVI was best predicted by novel body roundness index.