Celiac disease is an inflammatory disorder in which certain peptides from wheat and related grains trigger and maintain an immune reaction in the small intestine. Anorexia nervosa and bulimia nervosa are eating disorders that are morbid and, at times, life-threatening forms of psychopathology. Despite a large body of evidence describing the detrimental effects of eating disorders on the gastrointestinal system, information on the role of the gastrointestinal system in causing or mimicking eating disorders is scarce. To date, eating disorders, as a comorbid condition affecting individuals with celiac disease, has received surprisingly little attention with only a single report found in peer-reviewed literature. In this report, we describe a series of 10 individuals with both celiac disease and eating disorders. These cases demonstrate the complex ways in which celiac disease and eating disorders interact with important clinical implications for the diagnosis and treatment of both illnesses. Our findings suggest that clinicians treating patients with eating disorders or celiac disease should be aware of both conditions to provide optimum care.
The Celiac Center, Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Dana, Boston, Massachusetts, USA
Correspondence to Dr Daniel A. Leffler, MD, MS, Fellow in Gastroenterology, Beth Israel Deaconess Medical Center, Dana 501, 330, Brookline Avenue, Boston, MA 02215, USA
Tel: +1 617 667 2136; fax: +1 617 667 2767;
Sponsorship: Funding for this manuscript was supported in part by an NIH T32 Educational Grant.
Received 16 June 2006 Accepted 2 November 2006