Gastrointestinal diagnoses in patients with eating disorders: A retrospective cohort study 2010–2020

Abstract

Background and AimsGastrointestinal (GI) disorders are common in patients with eating disorders. However, the temporal relationship between GI and eating disorder symptoms has not been explored. We aimed to evaluate GI disorders among patients with eating disorders, their relative timing, and the relationship between GI diagnoses and eating disorder remission.MethodsWe conducted a retrospective analysis of patients with an eating disorder diagnosis who had a GI encounter from 2010 to 2020. GI diagnoses and timing of eating disorder onset were abstracted from chart review. Coders applied DSM‐5 criteria for eating disorders at the time of GI consult to determine eating disorder remission status.ResultsOf 344 patients with an eating disorder diagnosis and GI consult, the majority (255/344, 74.2%) were diagnosed with an eating disorder prior to GI consult (preexisting eating disorder). GI diagnoses categorized as functional/motility disorders were most common among the cohort (57.3%), particularly in those with preexisting eating disorders (62.5%). 113 (44.3%) patients with preexisting eating disorders were not in remission at GI consult, which was associated with being underweight (OR 0.13, 95% CI 0.04–0.46, p < 0.001) and increasing number of GI diagnoses (OR 0.47 per diagnosis, 95% CI 0.26–0.85, p = 0.01).ConclusionsEating disorder symptoms precede GI consult for most patients, particularly in functional/motility disorders. As almost half of eating disorder patients are not in remission at GI consult. GI providers have an important role in screening for eating disorders. Further prospective research is needed to understand the complex relationship between eating disorders and GI symptoms.

Fatty Acids and Their Lipogenic Enzymes in Anorexia Nervosa Clinical Subtypes

“…This is a novel finding supporting AN as a "metabopsychiatric disorder" [28] that displays an abnormal response to diet. Delayed gastric emptying and intestinal transit in AN [81] may account partially for the lack of significant FA changes in AN; however, other GI medical comorbidities commonly present in AN [82] may also disrupt lipid uptake after eating. Notably, directionally opposite changes were observed between the two AN subtypes for lauric acid and ELOVL2 levels after eating.…”