Here’s a sad thought: Not every child can enjoy the occasional ice cream cone or candy bar with reckless abandon.

For those with type 1 diabetes or chronic gastrointestinal disease, diets have to be closely monitored.

It’s important for physicians to be aware of these outcomes and work to optimally manage food perceptions.

 

Proposed mechanism

Authors of a review published in Advances in Nutrition hypothesized how treatment of diet-related chronic health conditions (DRCHCs) such as inflammatory bowel disease (IBD), type 1 diabetes mellitus (T1DM), cystic fibrosis (CF), and irritable bowel syndrome can eventually result in eating disorders.

Quick VM, Byrd-Bredbenner C, Neumark-Sztainer D. Chronic illness and disordered eating: a discussion of the literature. Adv Nutr. 2013;4(3):277–286.

 

These diseases require patients to follow a lifelong diet. The diets place pressure on kids that can result in destructive perceptions of food and body weight, as well as unhealthy eating habits.

Increased concern over body weight and diet in children with DRHCs compared with their healthy cohorts could then lead to disordered eating such as binging, purging, or extreme dieting, which could lead to eating disorders.

“Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population,” the authors wrote, “overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment.”

In a review published in the International Journal of Eating Disorders, researchers found that diet-treated chronic illness was related to disordered eating as well as eating disorders.

Conviser JH, Fisher SD, McColley SA. Are children with chronic illnesses requiring dietary therapy at risk for disordered eating or eating disorders? A systematic review. Int J Eat Disord. 2018;51(3):187–213.

 

The researchers found that disordered eating alongside unhealthy weight management increased the risk that children would experience poor clinical outcomes.

 

Repercussions

Results of a systematic review and meta-analysis published in PLOS ONE showed that disordered eating attitudes and behaviors predicted lower health-related quality of life (HRQOL) in children and teens compared with their healthy peers.

Wu XY, Yin WQ, Sun HW, et al. The association between disordered eating and health-related quality of life among children and adolescents: A systematic review of population-based studies. PLoS One. 2019;14(10):e0222777.

 Similarly, disordered eating correlated with diminished psychosocial health.

 

The authors suggested that “health programs for promoting healthy eating and reducing disordered eating behaviors among school children and adolescents may help to enhance the HRQOL and overall health status of these individuals.”

 

What can be done

Authors of the review published in Advances in Nutrition mentioned interventions intended to curb the risk of eating disorders in children with DRHCs.

At routine visits, children can be screened early to combat negative body image and disordered eating. When identified, providers can intervene before harmful attitudes and behaviors change into eating disorders.

Healthcare providers should be aware that young people with DRCHCs may be at risk of eating disorders, and carefully monitor psychological changes and the use of unhealthy weight control methods.

Clinicians can also be better trained on how to detect and treat disordered eating. Previous research has demonstrated that physicians who treat T1DM, for instance, have limited training in eating disorder management.

The authors stressed that it’s imperative to develop effective intervention and screening tools. These could cease the progression to eating disorders and mitigate detrimental health outcomes in younger people with DRCHCs.

Authors of the review published in International Journal of Eating Disorders pointed out the conundrum that clinicians face. Diet-treated chronic illness needs young people to closely consider diet and weight, but doing so may increase the odds of disordered eating.

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.