Evaluating disorders of gut‐brain interaction in eating disorders

Abstract

Objective Eating disorders commonly co‐occur with gastrointestinal problems. This case–control study aimed to (a) document the prevalence of disorders of gut‐brain interaction (DGBI) in eating disorders, (b) examine the specific impact of disordered eating behaviors on the risk of DGBI, and (c) explore the impact of current eating disorder psychopathology on DGBI. Method We included 765 cases with eating disorders and 1,240 controls. DGBI were assessed via the ROME III questionnaire. Prevalences of DGBI were calculated across eating disorder diagnoses (anorexia nervosa, bulimia nervosa, and multiple eating disorders) and in controls. The association between disordered eating behaviors and DGBI was examined using logistic regression models. Lastly, we compared the total number of DGBI in individuals with high versus low current eating disorder symptoms. Results A large majority (88.2–95.5%) of individuals with eating disorders reported at least one DGBI and 34.8–48.7% reported three or more DGBI. Of the DGBI categories, functional bowel disorders were the most commonly endorsed category, and of the individual DGBI, irritable bowel syndrome was the most frequently reported (43.9–58.8%). All investigated disordered eating behaviors showed a positive association with most DGBI categories. Finally, individuals reporting high current eating disorder symptoms reported higher mean number of DGBI (3.03–3.34) than those with low current symptoms (1.60–1.84). Discussion The directionality and mechanisms underlying the nature of the relationship between gastrointestinal and eating disorder symptoms is worthy of further study and clinicians should adopt an integrated approach by attending to both gastrointestinal and eating disorder symptoms in their patients.

Gastrointestinal Interoception in Eating Disorders: Charting a New Path

“…In clinical settings, patients with AN commonly report gastrointestinal complaints such as exaggerated fullness in response to small meals (i.e., postprandial fullness), early satiety, and abdominal pain [39 •]. They also report bowel and bladder symptoms outside of mealtimes, such as fullness, bloating, and constipation [40][41][42], and frequently exhibit gastrointestinal disorders [43] as well as functional gastrointestinal disorders [44]. The physiology underlying these abnormal perceptions has not been examined extensively in laboratory settings.…”

Orthorexia nervosa is a concern in gastroenterology: A scoping review

“…13 The presence of at least one DGBI in individuals with ED has been shown to be as high as 95.5%. 14 Diagnosis of ARFID has been reported to occur frequently in patients with gastroparesis 15 and inflammatory bowel disease, 16 and ARFID symptoms are often related to fear of gastrointestinal symptoms in patients with DGBI. 17 Recent studies investigating ARFID in irritable bowel syndrome (IBS) have shown those with severe food avoidance and restriction have more severe symptoms overall, reduced quality of life and reduced nutrient intake.…”

“…• Case-control study showed 88.2% of people with anorexia and 94.7% of people with bulimia had at least one DGBI14 …”

Eating disorders treatment experiences and social support: Perspectives from service seekers in mainland China

“…These results demonstrate treatment barriers created by discrepancies between how service is provided in a Westernized medical system and the cultural presentations of a condition, highlighting the importance of culturally responsive research and noting limitations in research generalizability (Ma et al, in press; Simons, Shoda, & Lindsay, 2017). In addition, EDs commonly co‐occur with problems in the gastrointestinal system and the communications along the gut‐brain axis may have important implications in ED research (Hooks, Konsman, & O'Malley, 2019; Murray et al, 2020; Wiklund, Rania, Kuja‐Halkola, Thornton, & Bulik, 2021). It is also possible that the participants experienced both gastrointestinal and disordered eating symptoms but sought treatment for the gastrointestinal problems because it is more culturally sanctioned to report an illness traditionally classified as physical versus mental.…”