According to a retrospective study published last October in the Journal of the American Academy of Dermatology, patients with atopic dermatitis (eczema) may be at increased risk for developing eating disorders.
Data for the study were obtained from the Finnish Care Register for Health Care database for patients diagnosed with eczema from 1987 to 2018. Only patients younger than age 18 years at the time of their first diagnosis were included. The Finnish Population Register Center database was used to obtain data for a group of age- and sex-matched control individuals.
A total of 70,584 patients with eczema were considered, 57% male with a mean age for the onset of eating disorders of 16.4 years. 270,783 control participants of which 51.7% were male with a mean age for onset of eating disorders of 16.1 were included.
Adjusting for birth year, sex, depression, anxiety, and food allergy, patients with eczema had increased odds of developing any eating disorder compared with control individuals at ages 18 and 30 years. The strongest associations between eczema and eating disorders was for bulimia nervosa, where those with eczema were 2.31 times more likely to develop the disorder at age 18, followed by binge-eating disorder where those with eczema were 1.86 times more likely to develop the disorder at age 18.
Said the researchers:
A negative cutaneous body image may be the link between AD [atopic dermatitis] and mental disorders because both AD and [eating disorders] have been shown to be associated with a disturbed body image, and negative attitudes toward weight, body, and eating are important factors influencing the onset and maintenance of [eating disorders].
Food allergies are significantly more prevalent in people with eczema, commonly attributed to the “atopic march” where children with eczema often go on to develop food allergies and asthma later in childhood. Although the researchers searched for evidence linking food allergies and eating disorders, they didn’t find compelling evidence for such an association.
The researchers specifically stated:
The high prevalence of food allergies in the atopic dermatitis population did not seem to explain the co-occurrence of atopic dermatitis and eating disorders.
Summarizing their analysis, the researchers concluded:
Our findings suggest that atopic dermatitis patients may be at particular risk of concomitant eating disorders. Hence, it is important to be aware of the cutaneous signs of hidden eating disorders as well as discuss eating habits and possible anxiety related to food in patients with atopic dermatitis.