Disordered eating behaviors in adolescents with celiac disease
Celiac disease (CD) is a chronic immune-mediated systemic disease characterized by inflammation and villous atrophy of the small intestine. A strict, lifelong gluten-free diet (GFD) is the only treatment for CD. Disordered eating behaviors (DEBs) prevail in adolescence and young adulthood, and confer a risk of developing into full-blown eating disorders. The aims of the current study were to assess the incidence and risk factors for DEBs among individuals with CD, and to examine an association between adherence to GFD and DEBs.
A cohort of 136 individuals with CD responded to a web-mediated survey that assessed DEBs and adherence to a GFD. The survey included demographic data (gender, age, weight, disease duration) and two self-rating questionnaires: the Eating Attitudes Test-26 and the gluten-free diet questionnaire.
DEBs were found in 19% of female and 7% of male responders. These individuals were characterized by being overweight (p = 0.02), of an older age (p = 0.04) and female sex (p = 0.06). Strict adherence to a GFD was reported by 32% of the responders and was not correlated with age, disease duration, age at diagnosis of CD and with being overweight.
Caregivers should be aware of the increased occurrence of DEBs in adolescents with CD, especially those who are overweight, older and of a female gender.
Level of evidence
Level V, cross-sectional descriptive study.
KeywordsCeliac disease Disordered eating behaviors Adolescents Eating disorders Gluten-free diet
Body mass index
Disordered eating behaviors
Eating Attitudes Test-26
The authors are thankful to the National Celiac Organization in Israel for their assistance in distributing the questionnaires via the web.
ITL, LGL, DS, BW and OPH, the authors, vow the presentation of information was not influenced by any personal or financial relationship with other people or organizations.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare they have no competing interests, e.g., financial, political, personal, religious, ideological, academic, intellectual and commercial in relation to this manuscript. All authors vow that there are no conflicts of interest in the manuscript, including financial, consultant, institutional and other relationships that might lead to bias.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Chaim Sheba Medical Center research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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