Can eating disorders be related to celiac disease?

As the link between celiac disease and psychological conditions is becoming increasingly clear, it should not come as a surprise that researchers have identified a connection between eating disorders, such as anorexia and bulimia, and celiac disease. After all, both conditions have the patient’s diet as the central point. Leaving many to wonder if eating disorders can be related to celiac disease.

Not an easy connection to spot

However, this link is not always a straightforward one: in some patients, it can be a genuine case of suffering from both celiac disease and an eating disorder, while in others, it’s a case of wrong diagnosis, with celiac disease “disguised” as anorexia or bulimia. Not surprising as undiagnosed celiac disease often results in weight loss due to malnutrition. These patients experience weight loss while eating large amounts of food each day. A signal that this kind of weight loss is not due to an eating disorder but is an indicator of celiac disease. To add to the confusion, some celiac patients end up developing an eating disorder triggered by the restrictive gluten-free diet, while for others, poor eating habits may trigger celiac disease.

It is an almost impossible task for physicians to differentiate between each case and offer suitable diagnosis, which can delay treatment and patient support, if needed. It can be very difficult to understand if the patient has a real eating disorder, just aversion to food caused by celiac disease, or both.

It can be challenging for patients with both conditions

If facing either condition by itself can be difficult, for patients struggling with both is a double challenge. An eating disorder already leaves patients anxious and stressed about what they eat, and celiac disease adds a new fear of eating something with gluten that is dangerous to their health and may trigger a gluten reaction.

This makes dietary compliance to a gluten-free diet even more urgent, but often results in weight gain, especially if relying on heavily processed foods. This is the number one fear for patients with an eating disorder, who may decide to sacrifice their own health to ensure continued weight loss.

In fact, for some patients, receiving a celiac disease diagnosis only worsens their eating disorder. Some use their celiac status as a “convenient excuse” not to eat and some even go as far as consuming gluten intentionally to facilitate weight loss.

Perhaps, this is where an early detection of celiac disease would prevent the eating disorder from developing. In addition, screening those with eating disorders to test for celiac disease could avoid the development of painful and uncomfortable symptoms, such as abdominal discomfort or diarrhea.

It’s true that practitioners are becoming more knowledgeable about celiac disease, but it’s also vital they develop skills to spot other conditions that may be associated with this disease. With the field of personalized medicine growing fast, this is an ideal situation to develop creative and individual approaches to treat each patient, involving nutritionists, gastroenterologists and psychologists.