E0634 - Disordered Eating in Adults With Gluten-Associated Disorders: The UCLA Celiac Collective

Introduction: Previous studies have identified disordered eating (DE) in up to 50% of adolescents and adults with gluten-associated disorders (GAD). Since a gluten-free diet (GFD) is the mainstay of therapy, non-adherence is associated with worse outcomes and decreased quality of life. Case studies and systematic studies have described reduced adherence to GFD in individuals with comorbid celiac disease and DE. Our aim was to assess this correlation in a cohort of patients with GAD.

Methods: Participants in the UCLA Celiac Disease Collective registry completed multiple validated patient-reported outcomes (PRO) surveys including the Celiac Dietary Adherence Test (CDAT), Celiac Symptom Index (CSI), and PRO Measurement Information System (PROMIS) for depression, anxiety, fatigue, and social interaction satisfaction. In addition, they completed the 28-item self-report questionnaire Eating Disorder Examination Questionnaire (EDE-Q 6.0), a validated tool for evaluating eating disorder pathology using four subscales (restraint, eating concern, shape concern, weight concern) and a global score.

Results: Preliminary results show that more than 50% of participants with GAD have significant DE, comparable to previous data in CD. Individuals with GAD have higher global EDE-Q scores compared to the general population. Worse GFD adherence correlates with higher EDE-Q score, which was statistically significant in the eating concern domain with a trend for restraint, shape concern, and weight concern domains, and global score. Participants with comorbid DE have worse symptom severity and higher prevalence of depression and anxiety. Severity of DE is also associated with comorbid fatigue and decreased social interaction satisfaction.

Discussion: This study is the first to show that adults with comorbid GAD and DE have worse disease activity and psychological distress. It supports previous studies associating DE with GFD non-adherence. Providers are advised to screen for DE in their GAD population.