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Celiac.com 02/27/2019 - To avoid the chronic inflammation, discomfort and damage associated with celiac disease, celiac patients need to follow a strict, lifelong gluten-free diet. That can be a challenge for teens and young adults, as shown by a number of earlier studies. Some studies have indicated that the challenge of following a gluten-free diet can cause stress and raise the risk for disordered eating behavior in some people. Teens and young adults with disordered eating behaviors face a greater risk of developing full-blown eating disorders. To better understand the issues involved, a team of researchers recently set out to assess the incidence and risk factors for disordered eating behaviors among individuals with celiac disease, and to examine a connection between a gluten-free diet and disordered eating behaviors. The Israeli research team included Itay Tokatly Latzer, Liat Lerner-Geva, Daniel Stein, Batia Weiss, and Orit Pinhas-Hamiel. For their Level V, cross-sectional descriptive study, the team submitted a personal and dietary survey that included questions on gender, age, weight, disease duration, along with two self-rating questionnaires that assessed disordered eating behaviors and adherence to a gluten-free diet: the Eating Attitudes Test-26 and the gluten-free diet questionnaire. They collected a total of 136 responses from celiac disease patients. They found disordered eating behaviors (DEBs) in 7% of male and nearly 20% of female subjects. In general, patients who experienced disordered eating were overweight, older, and female. About one in three patients reported strict adherence to a gluten-free diet, independent of age, disease duration, age at diagnosis of celiac disease, or being overweight. According to this data, a significant number of adolescents with celiac disease experience disordered eating patterns, especially those who are overweight, older and female. Extra attention to this issue might help to disrupt these patterns and to prevent them from becoming worse in the future. Read more at Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Celiac.com 04/06/2017 - A new study showing connections between anorexia nervosa and celiac disease, both before and after celiac diagnosis, is raising eyebrows and inviting questions. Results of the study appear in the April 3 issue of Pediatrics. Because the two conditions share a number of symptoms, including abdominal pain, bloating, diarrhea, and underweight, doctors can have some difficulty telling them apart. Until now, previous data linking anorexia with celiac disease came mostly from individual case reports. To get a better picture, Karl Mårild, MD, PhD, from the Barbara Davis Center, University of Colorado, Aurora, and colleagues conducted a cohort and case-control investigation examining the connection between celiac disease and timing of diagnosis for anorexia nervosa. To do this, the research team reviewed records from Sweden's 28 pathology departments. They looked at 17,959 cases of small intestinal biopsy-verified celiac disease in women from 1969 through 2008, and compared them with 89,379 sex- and age-matched population-based controls. The team confirmed cases of anorexia nervosa through inpatient and hospital-based outpatient records. They also looked at individuals undergoing biopsy who showed small intestinal inflammation or normal mucosa, but tested positive for celiac-related autoantibodies. They recorded educational level, socioeconomic status, and type 1 diabetes status. Their results showed that the hazard ratio for developing anorexia nervosa after a celiac diagnosis was 1.46, which fell to 1.31 beyond the first year after celiac diagnosis (with a 95% confidence interval for both). The odds ratio for association of previous anorexia nervosa diagnosis among people with a diagnosis of celiac disease was 2.18, with a 95% CI. The findings remain the same, even after the team adjusted for type 1 diabetes status and socioeconomic levels. Women who had positive celiac serology, but with no signs of villous atrophy, were also more likely to be diagnosed with anorexia nervosa, both before and after celiac diagnosis. The researchers propose three explanations for these findings: First, celiac disease may have been misdiagnosed earlier as anorexia nervosa, or vice versa. Second, it's possible that closer scrutiny of patients diagnosed with one condition may have prompted a bias in detecting the second condition. Third, it's possible that people with a shared genetic susceptibility may face a higher risk of developing both conditions. Whatever the reason behind the association, the study indicates that the connections between the two conditions are likely complex, and definitely invites further study. In the meantime, the researchers write that the "bidirectional association between diagnosis of anorexia nervosa and celiac disease warrants attention in both the initial assessment, and in the follow-up of women with these illnesses." As a result of this study, the team encourages "physicians to closely monitor these patients and calls for heightened understanding of factors that contribute to their co-occurrence." Source: Pediatrics. Published online April 3, 2017