Young patients with chronic disorders need to follow strict diets, which can lead to life-threatening eating disorders. Hence, this article assists physicians to understand the outcomes of their food perceptions towards young patients and guide them on how to manage such disorders. 

Here’s a sad thought

1. Not every child can enjoy the occasional ice cream cone or candy bar with reckless abandon.
2. For those with type 1 diabetes or chronic gastrointestinal disease, diets have to be closely monitored.
3. Strict diets, however, can place young patients down a path that begins with altered perceptions about food and possibly ends with a life-altering eating disorder.
4. It’s important for physicians to be aware of these outcomes and work to optimally manage food perceptions.

Proposed mechanism

1. Authors of a review published in Advances in Nutrition hypothesised how treatment of diet-related chronic health conditions (DRCHCs) which can eventually result in eating disorders such as:

• Inflammatory bowel disease (IBD)
• Type 1 diabetes mellitus (T1DM)
• Cystic fibrosis (CF)
• Irritable bowel syndrome

2. 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.

3. 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.

 The authors wrote:

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

4. 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.

5. Treating chronic illness with diet preceded disordered eating in diabetes, celiac disease, and GI disorders—but not IBD.

6. 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 behaviours predicted lower health-related quality of life (HRQOL) in children and teens compared with their healthy peers.  Similarly, disordered eating correlated with diminished psychosocial health.

The authors suggested that,

“Health programs for promoting healthy eating and reducing disordered eating behaviours among school children and adolescents may help to enhance the HRQOL and overall health status of these individuals.”

What can be done

The 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 behaviours change into eating disorders.

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.

The authors of the review published in the 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 behaviours of the child, parents/care providers, family, and treatment providers.”

— Conviser, et al.

Disclaimer: This story is contributed by Naveed Saleh and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.