Researchers have found that dietary therapy in children with chronic illnesses, such as inflammatory bowel disease (IBD), may increase their risk for unusual eating habits or eating disorders.
The review study, “Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review,” was published in the journal International Journal of Eating Disorders.
Children with chronic illnesses may require a dietary regimen as part of their therapy, making disease-specific changes in diet to improve their health.
The recommended dietary guidelines go beyond the normal indications for healthy people, addressing the issues of the chronic condition.
For instance, particular dietary recommendations are suggested by the Crohn’s & Colitis Foundation to reduce and control IBD symptoms.
But compliance with a strict diet and exposure to parental overcontrol of feeding may raise the risk for eating disorders.
Therefore, children with chronic diseases who require a strict dietary regimen may be at higher risk of disordered eating behaviors and eating disorders, which may result in serious medical consequences.
A team of researchers analyzed data from a large number of previous research studies to understand if a diet treatment can lead to disordered eating in children with diabetes, cystic fibrosis, celiac disease, gastrointestinal disorders, and IBD.
They searched for several unusual eating behaviors (such as overly restrictive dieting and binge eating) and eating disorders including anorexia nervosa, bulimia nervosa, binge-eating, or avoidant restrictive food intake disorder.
The data, from 86 studies that met the criteria, indicates that children with diabetes, CF, celiac, gastrointestinal disorders, and IBD have a higher likelihood of experiencing disordered eating habits or developing an eating disorder during their childhood.
Except for IBD, in most studies the dietary therapy started before the disordered eating, which supports the onset of diet therapy as the cause for the appearance of pathological eating behaviors.
Studies about gastrointestinal disorders and IBD provided solid evidence that children with eating disorders are affected at a higher rate by these conditions.
Between 97% and 98% of inpatients with an eating disorder had a gastrointestinal disorder; 53% had three or more gastrointestinal disorders; and 77% continued to have a gastrointestinal disorder at a 12-month follow-up.
Another study reports that 75% of children with anorexia had GI disorders, compared with 18% of healthy children, or controls. Irritable bowel syndrome (IBS) was the most common gastrointestinal disorder in children with anorexia.
Another report found that children with IBS had more unhealthy eating habits than children with inflammatory bowel disease and controls.
Taken together, the review study shows that children with diet-treated chronic illnesses are at risk for developing eating disorders and that the diet therapy generally precedes the onset of unusual eating habits or a diagnosable eating disorder.
This pattern was most noticeable in children with diabetes and cystic fibrosis, for which there were more available studies.
“Disordered eating and unhealthy weight management practices put children at risk for poor medical outcomes,” researchers wrote.
“Future research is needed to elucidate the mechanisms that transform standard treatment practices into pathological eating, including characteristics and behaviors of the child, parents/care providers, family, and treatment providers,” they added.