Celiac Disease Linked to Depression, Disordered Eating in Women

Women who suffer from celiac disease are more likely to report symptoms of depression and disordered eating, even if they follow a gluten-free diet, researchers have found.

Celiac disease is an autoimmune disorder marked by negative reactions to eating gluten, including abdominal pain, constipation, decreased appetite, diarrhea, nausea, and vomiting. People with celiac generally control the symptoms by following a gluten-free diet that excludes foods such as wheat, barley, and rye.

The researchers used a Web-based survey to evaluate a range of physical, behavioral and emotional experiences in 177 American women with celiac disease. Among the topics covered were how well participants adhered to a gluten-free diet and the nature of their celiac symptoms. The researchers did not include individuals without celiac disease, but they did compare the results of the survey to data collected previously from the non-celiac population.

“We found that most participants frequently adhered to a gluten-free diet, and this greater compliance with diet was related to increased vitality, lower stress, decreased depressive symptoms and greater overall emotional health," said Josh Smyth, professor of biobehavioral health and medicine at Penn State University, in a press release. "However, even those people who were managing their illness very well reported higher rates of stress, depression, and a range of issues clustered around body dissatisfaction, weight, and shape when compared to the general population."

Of the 177 participants, 65 (37%) met the threshold for depression, and 39 (22%) for disordered eating.

Smyth suggested that some of the participants’ depression is attributable to psychological factors associated with social gatherings at restaurants, which could also be the case for individuals with food allergies, diabetes, Crohn's disease, and other conditions that require avoiding particular foods.

"Going out to eat with friends or to a holiday potluck is a much different experience for these people because they have to be vigilant and monitor their diets," Smyth said. "They may feel that they are a burden on a host or hostess. In many cases the only treatment option they are given is to manage their diets.”

Smyth stated "it's likely that the disease, stress, weight, shape and eating issues, and depression are interconnected,” but he also noted that the researchers are unsure at this point which comes first for women with celiac disease: depression or disordered eating.

“In the future, we plan to investigate the temporal sequence of these symptoms,” he concluded.

The study has been posted online and will appear in a future issue of Chronic Illness.