Functional gastrointestinal symptoms and increased risk for orthorexia nervosa

Gajdos, Panna; Román, Nóra; Tóth‐Király, István; Rigó, Adrien

doi:10.1007/s40519-021-01242-0

Cited by 11 publications

(14 citation statements)

References 53 publications

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“…Clinicians have reported concern regarding disordered eating in DGBI patient cohort. 97 • Recent cross-sectional study of 644 Hungarian volunteers (published since our search was conducted) showed gastrointestinal symptoms were positively associated with orthorexia nervosa and emotional eating 110 • A prospective study of 233 IBS patients commencing a low FODMAP diet found that 23% of patients were classified to be at risk of disordered eating. Adherence to the diet was higher (57%) in those at risk of ED compared to those who were not (35%).…”

Section: Early Data Suggest Link Between Dgbi and Orthorexiamentioning

confidence: 99%

“… Disordered eating behaviors may precede IBS ED‐related malnutrition impacts electrolyte depletion influencing gastric motility and emptying 103 Refeeding therapy improves gastrointestinal symptoms 104 Bidirectional relationship via brain‐gut axis Anorexia displays different composition and diversity of microbiota compared to controls 105 Anorexia displays higher levels of methane‐producing bacteria linked to slow intestinal transit, 106 similar to differences in microbiota composition seen in patients with IBS compared to healthy controls 107 IBS leads to disordered eating IBS has higher rates of disordered eating behaviors compared to controls, for example, not eating when hungry and vomiting after eating to avoid symptoms, 108 which is correlated with symptom severity 109 Gastrointestinal symptom severity and orthorexia positively correlated 110 …”

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

“…IBS leads to disordered eating IBS has higher rates of disordered eating behaviors compared to controls, for example, not eating when hungry and vomiting after eating to avoid symptoms, 108 which is correlated with symptom severity 109 Gastrointestinal symptom severity and orthorexia positively correlated 110 …”

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

See 2 more Smart Citations

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

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There is concern that use of restrictive therapeutic diets, such as those used in disorders of the gut‐brain interaction (DGBI), may increase disordered eating. In this issue of Neurogastroenterology and Motility, Burton Murray et al. and Peters et al. both demonstrate a high prevalence of disordered eating in patients with gastrointestinal conditions, particularly those with DGBI. Given these findings, it is likely that orthorexia is common in this patient group, although this was not directly examined in these studies. Orthorexia nervosa is described as an obsessive and unsafe focus on eating foods perceived as healthy. This mini‐review therefore focuses on orthorexia by conducting a scoping review, as per the PRISMA extension for scoping reviews, aimed to assess the prevalence of orthorexia, and associations between orthorexia and restrictive eating practices. While a wide range of orthorexia prevalence has been reported (0%–97%) across the 57 studies included, no studies assessed prevalence specifically in gastrointestinal conditions. Four of eight studies describing diseases associated with specific dietary patterns suggested that participants who followed a diet for “digestive issues” or “food intolerances” were at higher orthorexia risk. These results suggest that dietary modifications may be a factor contributing to orthorexia. Additionally, we provide a commentary on the clinical implications of the findings for gastrointestinal conditions including a clinical flow chart. Clinicians should consider if a restrictive diet is appropriate for individuals with DGBI and include screening for disordered eating prior to implementation of dietary modifications. Future prospective studies should evaluate orthorexia within this patient group.

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Section: Early Data Suggest Link Between Dgbi and Orthorexiamentioning

confidence: 99%

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

Section: Clinical Implications In Gastroenterologymentioning

confidence: 99%

See 1 more Smart Citation

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Tuck

Sultan

Tonkovic

et al. 2022

Neurogastroenterology Motil

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“…Their study found that functional gastrointestinal symptoms were positively associated with symptoms of orthorexia nervosa and emotional eating. The relationship between functional gastrointestinal symptoms and symptoms of orthorexia nervosa was partially mediated by health anxiety [ 19 ]. In this setting, another paper highlighted a bidirectional relationship, since IBS symptoms are more common in patients with established eating disorders [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Food Beliefs and the Risk of Orthorexia in Patients with Inflammatory Bowel Disease

Di Giorgio,

Modica,

Saladino

et al. 2024

Nutrients

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Patients with inflammatory bowel disease (IBD) believe that diet plays a significant role in the pathogenesis of their disease and the exacerbation of their symptoms. They often adopt restrictive diets that can lead to malnutrition, anxiety, and stress. Recent studies have found a correlation between IBD and eating disorders, such as anorexia nervosa and ARFID (Avoidant Restrictive Food Intake Disorder). None of these studies report an association with orthorexia nervosa, which is an obsession with healthy and natural foods. The aim of this study was to assess the risk of orthorexia nervosa in patients with IBD. A total of 158 consecutive subjects were recruited, including 113 patients with IBD and 45 controls. The standardized Donini questionnaire ORTO-15 was administered to assess the risk of orthorexia, and clinical and demographic data were collected. The results showed that patients with IBD had a risk of developing orthorexia nervosa of 77%. This was significantly higher than the 47% observed in the control group. In the patients with IBD, the risk of orthorexia was associated with a lower BMI, at least in patients older than 30 years, and it was also associated with marital status in patients younger than 30. In conclusion, many patients with IBD are at increased risk of developing orthorexia nervosa, which may have a negative impact on their psychological wellbeing and social sphere, expose them to a high risk of nutritional deficiencies, and affect their overall quality of life. Further high-quality studies are needed to assess the clinical impact of orthorexia and its correlation with clinical features and classified eating disorders.

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“…However, preliminary research has found that IBS symptom severity may be positively correlated with orthorexia. 58,64 Various screening tools have been developed to assess risk of ARFID and orthorexia, but none have been validated in IBS. Considering that groundwork research has indicated a relationship between IBS and eating disorders, future research should explore this link further.…”

Section: Psychological Risksmentioning

confidence: 99%

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Sultan

Varney

Halmos

et al. 2022

J Neurogastroenterol Motil

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Background/AimsThe 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian's perspective. MethodsRecent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus. ResultsThe dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown. ConclusionWhile the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.

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Functional gastrointestinal symptoms and increased risk for orthorexia nervosa

Cited by 11 publications

References 53 publications

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Orthorexia nervosa is a concern in gastroenterology: A scoping review

Food Beliefs and the Risk of Orthorexia in Patients with Inflammatory Bowel Disease

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

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