Many young women struggle with anorexia nervosa for reasons that remain unclear. Biological, psychological and even environmental factors – Western culture's unhealthy obsession with being thin – all have their own camps and adherents. But new findings that link anorexia to celiac disease may finally shed some definitive light on the eating disorder which affects 1 in 200 American women.
Celiac disease is a serious digestive disorder, a genetic disease that affects 1 in 100 Americans. The disease damages the villi of thesmall intestine and interferes with the absorption of certain nutrients.
Scientists in Sweden have discovered that young women with celiac disease may face a heightened risk of being diagnosed with anorexia. The risk of anorexia was not brought on by the onset of celiac disease, but was present both before and after the celiac diagnosis.
The new study made use of Sweden's system of national registries, which allowed the researchers to examine records from nearly 18,000 women who'd had celiac disease definitively diagnosed through a biopsy of the small intestine. They cross-indexed these with over 89,000 other women who'd never been diagnosed with celiac disease. They found that the vast majority of women with celiac disease had no diagnosis of anorexia, but their risk was higher than the norm. Overall, they learned that women with celiac were twice as likely to be subsequently diagnosed with anorexia – even after factors like age and education levels were taken into account.
What's the science? Heads are still being scratched in Sweden, where the team acknowledge that there is no evidence that celiac disease causes anorexia. But in the U.S., there are some theories.
"I think a lot of us are aware there is a possibility of [celiac] patients developing an eating disorder," said Dr. Hilary Jericho, an assistant professor of pediatrics at the University of Chicago's School of Medicine, who specializes in treating celiac disease.
She believes that, since strict attention to diet is necessary for those living with celiac disease, many patients become overly rigid regarding what they eat. "That's true not only with celiac disease, but with other diseases that require dietary restrictions, like type 1 diabetes," Jericho noted.
Celiac disease is not an eating disorder, but people suffering from it may not eat any gluten to prevent the immune system from attacking the small intestine. It also has certain symptoms in common with anorexia, including weight loss, fatigue, and abdominal bloating in adults; and poor growth and delayed puberty in children.
Next steps? Jericho and her team are looking to study anxiety, depression and “coping skills” among celiac patients and examine to what degree these may affect future incidents of anorexia.
The research has been published in the journal Pediatrics.