Jump to content
Celiac Disease FAQ | This site uses cookies GDPR notice. Read more... ×
  • Sign Up
  • Join Our Community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Jefferson Adams
    Jefferson Adams
    0

    Study Shows Clear Link Between Celiac Disease and Anorexia Nervosa

      A new study shows that celiac disease and anorexia nervosa are connected, but how?

    Caption: Celiac disease and anorexia nervosa are connected, but how? Photo: CC--Benjamin Watson

    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:


    0


    User Feedback

    Recommended Comments

    When I was much younger, I knew a girl with anorexia. I couldn't understand it because I loved to eat. But after I figured out that I couldn't tolerate gluten, I experienced what it was like to be suspicious of everything that I put in my mouth, and I reminded myself of that young lady that I knew. So I wondered then if she might have been so cautious about food because it made her feel badly as it had begun to do with me.

    Share this comment


    Link to comment
    Share on other sites

    Among the reason they listed between anorexia and celiac they did not see the most obvious one: If a person with undiagnosed celiac gets pain, bloating and all the miserable feeling and health conveniences that come after ingesting gluten, it is to far fetched that they will stop eating all together? Especially a young person, if they had been tested for celiac and if was not confirmed--as it happened to me-- they could come to think that it is something of themselves that causes their symptoms and refuse to eat at all. As gluten is in all kinds of unsuspected forms and products it is highly possible that we have if ever time we eat. Undiagnosed celiac is gluten sensitivity CAN cause anorexia, simply because you don't want feel sick every time you eat.

    Share this comment


    Link to comment
    Share on other sites

    Your statement; " Anorexia, simply because you don't want feel sick every time you eat" is the only conclusion that deserves merit. Chronic gluten exposure resulted in my health down-spiral that led to severe malnutrition, peripheral neuralgia, encephalopathy and the eventual need for surgical intervention. Eating out? Forget it! Taking risks? NO more! I eat less because there is less to eat. Just how much plain beef, chicken, fruits & vegetables can one eat in a day? It was a sad time when the FDA did not intervene with wheat hybridization. The extensive ramifications were neither suspected nor proposed. Persons who state that gluten is good and more gluten is better should live in my shoes for one month: No gluten, egg, yeast, dairy, oils (except cold pressed), preservatives, artificial flavorings, coloring agents. This list of toxins has removed; 99% of processed foods from my grocery list and 100% of restaurants visits. Cross contamination is an unacceptable risk. The Cooperating Parties continue to modify reportable code sets for celiac and non-celiac gluten sensitivities. I project gluten will impact 15% of the population by 2027. We will see!

    Share this comment


    Link to comment
    Share on other sites

    I am riposting this, as it had many typos in the previous post: Among the reason they listed which link anorexia and celiac they did not see the most obvious one: a person with undiagnosed celiac gets pain, bloating and all the miserable feelings and health consequences that come after ingesting gluten. Is it too far fetched that they will stop eating all together? Especially a young person, if they had been tested for celiac and if it was not confirmed--as it happened to me-- they could come to think that it is something of themselves that causes their symptoms and refuse to eat at all. As gluten is in all kinds of unsuspected forms and products it is highly possible that we have it every time we eat. Undiagnosed celiac and gluten sensitivity CAN cause anorexia, simply because you don't want to feel sick every time you eat.

    Share this comment


    Link to comment
    Share on other sites
    Guest Jefferson Adams

    Posted

    Among the reason they listed between anorexia and celiac they did not see the most obvious one: If a person with undiagnosed celiac gets pain, bloating and all the miserable feeling and health conveniences that come after ingesting gluten, it is to far fetched that they will stop eating all together? Especially a young person, if they had been tested for celiac and if was not confirmed--as it happened to me-- they could come to think that it is something of themselves that causes their symptoms and refuse to eat at all. As gluten is in all kinds of unsuspected forms and products it is highly possible that we have if ever time we eat. Undiagnosed celiac is gluten sensitivity CAN cause anorexia, simply because you don't want feel sick every time you eat.

    My understanding is that anorexia nervosa is much more than simply avoiding food because one does not wish to get sick. It is a psychological and medical condition with clear features. As such, I'm not sure your hypothesis holds water. It may very well be the case that gluten damage and the desire to avoid it could be a contributing factor before diagnosis, but what about after? Most people with celiac disease work hard to avoid gluten once diagnosed, and most are usually successful, even with a steep learning curve and occasional contamination. As they find a diet that works for them, they get healthier. Since this study shows a connection both before and after diagnosis, the data indicate that the answer likely lies somewhere else.

    Share this comment


    Link to comment
    Share on other sites

    I can understand if there is a correlation between celiac disease and some anorexia cases, as your body will definitely tell you there is something wrong if you listen... It's sometimes really hard to figure it out though until you have to do something about it. I'm celiac with dairy, egg, yeast and additives allergies, which sometimes feels like l'm a walking science experiment. Still feels good to figure things out!

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoji are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

  • Related Articles

    Jefferson Adams
    Does Obesity Play a Major Role in Triggering Autoimmune Diseases?
    Celiac.com 11/28/2014 - According to a new study, obesity plays a major part in triggering and prolonging autoimmune diseases, such as celiac disease, Crohn's disease and multiple sclerosis.
    The study appeared recently in Autoimmunity Reviews by Prof. Yehuda Shoenfeld, the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases at Tel Aviv University's Sackler Faculty of Medicine and Head of Zabludowicz Center for Autoimmune Diseases at Chaim Sheba Medical Center, Tel Hashomer.
    According to the research, obesity erodes the body's ability to protect itself, triggering a pro-inflammatory environment that promotes the development of autoimmune diseases, hastens their progression, and impairs their treatment.
    For some time now, says Professor Shoenfeld, researchers have been aware of the “negative impact of contributing disease factors, such as infections, smoking, pesticide exposure, lack of vitamins, and the like. But in last five years, a new factor has emerged that cannot be ignored: obesity.”
    According to the World Health Organization, about one-third of the global population is overweight or obese, nearly a dozen autoimmune diseases are now associated with excess weight, which now impact nearly 5-20% of the global population. That is why, according to Shownfeld, it is “critical to investigate obesity's involvement in the pathology of such diseases."
    The main culprit is not fat itself, but adipokines, compounds secreted by fat tissue, which impact numerous physiological functions, including the immune response.
    In tandem with their own study, Shoenfeld and his colleagues reviewed 329 studies from across the globe that focused on the connections between obesity, adipokines, and immune-related conditions like rheumatoid arthritis, multiple sclerosis, type-1 diabetes, psoriasis, inflammatory bowel disease, psoriatic arthritis, and Hashimoto thyroiditis.
    "According to our study and the clinical and experimental data reviewed, the involvement of adipokines in the pathogenesis of these autoimmune diseases is clear," says Shoenfeld. "We were able to detail the metabolic and immunological activities of the main adipokines featured in the development and prognosis of several immune-related conditions."
    One of the team’s more interesting findings was that obesity also promotes vitamin D deficiency, which, “once corrected, alleviated paralysis and kidney deterioration associated with the disorder… [and] improved the prognosis and survival of the mice.”
    Source:
    Science Daily, November 10, 2014

    Jefferson Adams
    Celiac.com 04/06/2015 - Several studies have shown that many patients with celiac disease experience changes in body weight after starting a gluten-free diet, but researchers still don't have much data on rates of metabolic syndrome in this population.
    A team of researchers recently set out to assess rates of metabolic syndrome in patients with celiac at diagnosis, and at one year after starting gluten-free diet. The research team included R. Tortora, P. Capone, G. De Stefano, N. Imperatore, N. Gerbino, S. Donetto, V. Monaco, N. Caporaso, and A. Rispo. They are affiliated with the Department of Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy, or with the Department of Education and Professional Studies, King's College London, London, UK.
    For their study, the team enrolled all consecutive patients with newly diagnosed celiac disease who were referred to their third-level celiac disease unit. For all patients the team collected data on waist circumference, BMI, blood pressure, HDL cholesterol, triglycerides, and blood sugar levels.
    The team diagnosed metabolic syndrome according to the International Diabetes Federation (IDF) criteria for European countries. They reassessed rates of metabolic syndrome in patients after 12 months of gluten-free diet.
    The team assessed ninety-eight patients with celiac disease, two (2%) who fulfilled the diagnostic criteria for metabolic syndrome at diagnosis, and 29 patients (29.5%) after 12 months of gluten-free diet (P < 0.01; OR: 20).
    After 1 year on a gluten-free diet, the team compared the patient data to baseline, with respect to metabolic syndrome sub-categories. They found 72 vs. 48 patients exceeded waist circumference cut-off (P < 0.01; OR: 2.8); 18 vs. 4 patients had high blood pressure (P < 0.01; OR: 5.2); 25 vs. 7 patients exceeded glycemic threshold (P = 0.01; OR: 4.4); 34 vs. 32 patients with celiac disease had reduced levels of HDL cholesterol (P = 0.7); and 16 vs. 7 patients had high levels of triglycerides (P = 0.05).
    The results of this study show that celiac disease patients have a high risk of developing metabolic syndrome 1 year after starting a gluten-free diet.
    To address this, the research team recommends an in-depth nutritional assessment for all patients with celiac disease.
    Source: 
    Aliment Pharmacol Ther. 2015;41(4):352-359.

    Jefferson Adams
    Celiac.com 05/18/2016 - Common clinical wisdom, and some data, indicate that patients with celiac disease are likely to be underweight. However, data from west suggest that anywhere from 8% to 40% of celiac patients can be overweight or obese.
    What about normal weight? Can people with celiac disease also have normal body weight? A research team recently set out to determine if people with celiac disease can be normal weight. The research team included I Singh, A Agnihotri, A Sharma, AK Verma, P Das, B Thakur, V Sreenivas, SD Gupta, V Ahuja, and GK Makharia.
    They are variously affiliated with the Department of Gastroenterology and Human Nutrition, the Department of Pathology, the Department of Biostatistics, and the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.
    To answer that question, a team of researchers recently reviewed data on body mass index (BMI) of patients with celiac disease so they could correlate BMI with other celiac characteristics. For their retrospective study, the team reviewed case records of 210 adolescent and adult celiac patients who were seen at the team's Celiac Disease Clinic.
    To classify BMI as underweight, normal weight, overweight, or obese, they used the Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians for those with age >18 years and revised Indian Association of Pediatrics BMI-for-age charts for those between 12 and 18 years.
    Their results showed that, of 210 patients, 115 patients were normal weight, while 76 patients were underweight, 13 were overweight, and 6 were obese. There was no difference in the proportion of underweight between male and female patients with celiac disease.
    The mean age of underweight patients was similar to those who were normal or overweight. Regardless of weight, there was no difference between any of the patients in terms of average duration of symptoms; frequencies of diarrhea, anorexia, and weakness; anemia; titer of anti-tissue transglutaminase antibody; and severity of villous atrophy in those with underweight or normal weight or overweight.
    Of the celiac disease patients in this clinic, only one third of patients with celiac disease actually had low BMI. More than half had normal BMI, while the rest were either overweight or obese.
    Physicians should not discount the possibility of celiac disease based solely on BMI. Patients with normal and high BMI can also have celiac disease.
    Source:
     Indian J Gastroenterol. 2016 Jan;35(1):20-4. doi: 10.1007/s12664-016-0620-9. Epub 2016 Feb 18.

  • Popular Contributors

  • Forum Discussions

    Global Food Intolerance Products market report provides complete analysis with current and forthcoming opportunities to explain the future investment ... View the full article
    With Experts forecast, Gluten Free Foods & Beverages market is expected to ... Increasing Awareness of Celiac Disease and Gluten – Intolerance View the full article
    Rinsing it off under running water real good, this is to get any CC off. Examples, if there is a open air bakery some flour might have settled on your produce at the grocery store. OR if they are giving out samples some person might have been handling a dounut and touched your produce. Rinsing it off under running water works to remove any trace amounts normally.

    Organic. some people in general react to stuff used in growing produce, IE glyphostphate, or like me I have a issue with the wax they coat them with to keep the fresh. Going organic or farmers market fresh helps some with these. I think your nutritionist is covering all the bases.
×