Disordered eating behaviors in adolescents with celiac disease

  • Itay Tokatly LatzerEmail author
  • Liat Lerner-Geva
  • Daniel Stein
  • Batia Weiss
  • Orit Pinhas-Hamiel
Original Article



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.


Celiac disease Disordered eating behaviors Adolescents Eating disorders Gluten-free diet 



Body mass index


Celiac disease


Disordered eating behaviors


Eating Attitudes Test-26


Eating disorders


Gluten-free diet



The authors are thankful to the National Celiac Organization in Israel for their assistance in distributing the questionnaires via the web.

Author contributions

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.

Ethical standards

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Pediatrics ATel Aviv UniversityTel AvivIsrael
  2. 2.Gertner Institute for Epidemiology and Health Policy ResearchTel Aviv UniversityTel AvivIsrael
  3. 3.Pediatric Psychosomatic DepartmentTel Aviv UniversityTel AvivIsrael
  4. 4.Pediatric Gastroenterology UnitTel Aviv UniversityTel AvivIsrael
  5. 5.Pediatric Endocrine and Diabetes UnitChaim Sheba Medical CenterRamat-GanIsrael
  6. 6.Affiliated to the Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  7. 7.Department of PediatricsChaim Sheba Medical CenterTel HashomerIsrael

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