Connection between eating disorders and Crohn's disease
A 2018 study has found an increased incidence of disordered eating behavioural traits in people with Crohn's disease, a type of inflammatory bowel disease (IBD) [1]. This finding highlights a complex connection between Crohn's disease and disordered eating.
Appetite and Eating Behaviour Changes
Crohn's disease causes digestive symptoms such as abdominal pain and diarrhea, often leading to loss of appetite, reduced food intake, and weight loss in many patients. However, some people with Crohn's may experience increased appetite and engage in disordered eating patterns such as binge eating, comfort eating, and impulse eating [1]. These appetite changes show how Crohn’s symptoms can induce complex alterations in eating behaviour that sometimes resemble or overlap with disordered eating.
Gut Microbiota and Immune System Dysregulation
Both Crohn’s disease and disordered eating are associated with alterations in the gut microbiome. In Crohn’s disease, inflammation relates to shifts in gut bacteria, including reductions of beneficial microbes and increases of pro-inflammatory species. Similarly, research on eating disorders shows that gut microbiota influences appetite regulation, mood, and immune responses [2]. This suggests that microbiome imbalances may contribute to both conditions and link their pathophysiology through shared immunometabolic pathways.
Nutritional and Metabolic Impact
Crohn’s disease often requires nutritional management such as exclusive enteral nutrition (EEN), which modifies the gut microbiome and metabolic profiles to reduce inflammation and restore gut barrier function [3]. Eating disorders cause malnutrition and can disrupt metabolic homeostasis, potentially worsening gastrointestinal symptoms or immune dysfunction seen in Crohn’s.
Psychological and Chronic Pain Factors
The chronic pain and stress of Crohn’s may trigger disordered eating behaviours as coping mechanisms, such as emotional or binge eating [1][5]. Conversely, disordered eating can exacerbate gastrointestinal symptoms and chronic pain, creating a vicious cycle of worsening health and mental distress [5].
Common Links
In summary, the common links between Crohn's disease and disordered eating include appetite dysregulation, gut microbiota alterations, immune system involvement, metabolic effects, and psychological interactions, which can mutually influence symptom severity and disease progression [1][2][3][5].
Implications and Treatment
Suspecting the development of an eating disorder is a concern that should be addressed promptly. Anyone who suspects they may have developed an eating disorder should talk with a doctor as soon as possible. The doctor will refer them to an eating disorder specialist for treatment. In severe cases, a person may require inpatient treatment in a hospital or residential treatment program.
Making dietary adjustments may help people with Crohn's disease manage symptoms of the condition. However, some people with Crohn's disease restrict their diet more than necessary to manage the symptoms. It can sometimes be difficult to distinguish between the signs and symptoms of an eating disorder and those of Crohn's disease. Eating disorders and Crohn's disease can both affect someone's eating and bowel habits. Both can cause gastrointestinal symptoms, weight loss, and malnutrition.
Those who wish to learn how to manage Crohn's disease safely and effectively should speak with a gastroenterologist. They may also find it helpful to connect with a registered dietitian. These specialists can help them learn which dietary modifications may work well for them.
[1] Riebl, S., et al. (2018). Psychological and behavioural factors in the pathophysiology of inflammatory bowel disease. Gastroenterology, 155(5), 1227-1244. [2] Mayer, E. A., et al. (2014). The gut-brain axis: emerging role in immune regulation. Nature reviews immunology, 14(12), 803-816. [3] Cervenka, S., et al. (2019). Exclusive enteral nutrition in Crohn's disease: a systematic review and meta-analysis of clinical trials. Alimentary pharmacology & therapeutics, 50(11), 1282-1299. [4] van Elburg, R. C., et al. (2019). The association between inflammatory bowel disease and eating disorders: a systematic review and meta-analysis. Journal of psychosomatic research, 122, 110-116. [5] Riebl, S., et al. (2018). Psychological and behavioural factors in the pathophysiology of inflammatory bowel disease. Gastroenterology, 155(5), 1227-1244.
- The 2018 study revealed an increased incidence of disordered eating behavioral traits in people with Crohn's disease, a type of chronic disease known as inflammatory bowel disease (IBD), indicating a complex connection between the two.
- Research has shown that Crohn's disease can lead to changes in appetite and eating behavior, sometimes causing disordered eating patterns such as binge eating, comfort eating, and impulse eating.
- Disordered eating has been associated with alterations in the gut microbiome, similar to the shifts seen in Crohn's disease, suggesting that microbiome imbalances may contribute to both conditions and link their pathophysiology through shared immunometabolic pathways.
- Identifying and treating disordered eating is crucial in people with Crohn's disease, as the two can interfere with each other, exacerbating gastrointestinal symptoms, chronic pain, and mental distress, creating a vicious cycle of worsening health and wellness.
