Adolescents and young adults with chronic disease at higher risk for eating disorders

Chronic health conditions such as cystic fibrosis, diabetes, inflammatory bowel disease, and irritable bowel syndrome require patients to adhere to prescribed diets, usually for a lifetime. Complying with these restrictive diets is difficult for anyone, but particularly for young people, as they are more likely to develop destructive attitude toward food and body image as well as unhealthy eating habits and disorders such as binge eating, anorexia, and bulimia.

A review published in the May 15, 2013 issue of Advances in Nutrition, “Chronic Illness and Disordered Eating: A Discussion of the Literature,” explores the relationship between chronic health conditions that necessitate specific dietary modifications and eating disorders among adolescents and young adults.

Although there have been no comprehensive studies of the relationship between chronic disease and eating disorders among adolescents and young adults, some significant research has been conducted examining the impact of specific chronic diseases and their effect on eating habits. For example, a study of adolescents with celiac disease determined that the rates of eating disorders among female patients were substantially higher than estimates for the general population.

The review also pointed to studies of eating disorders among young women with type 1 diabetes. These studies suggest that the need to constantly follow a strict diet and frequently monitor blood sugar levels may cause young women with diabetes to become overly concerned with their diets. Managing and restricting diet is especially difficult for adolescents with diabetes when they see friends and family who are able to eat whenever and whatever they want. Over time, this constant awareness of diet and disease treatment may lead to unhealthy eating habits and eating disorders.

Coping with a chronic disease is never easy; however, coping with chronic disease as an adolescent—a time of rapid growth, development, and socialization—can be even more challenging. Medical treatment may slow normal growth and result in shorter stature, delayed onset of puberty and malnutrition. Visible signs of illness may cause embarrassment which can lead to poor body image and development of eating disorders.

Given the generally higher rate of unhealthy eating habits during adolescence and young adulthood and the negative health implications that these habits may have for those with chronic health conditions, the authors of the Advances in Nutrition review believe more research is needed to help young people with chronic disease maintain safe, healthy eating habits. In particular, the authors call for the development of quick screening tools to assess negative body image and unhealthy eating habits among youths with chronic health conditions. By consistently assessing key markers of negative body image and unhealthy eating, health care providers can intervene early before these negative attitude and behaviour progress to serious, life-threatening eating disorders.