FeaturesAug/Sep 2012 Issue

Celiac Disease and Eating Disorders

A closer look at the link


When Beth was 19 and a sophomore in college, she began to cut back on how much she was eating. In high school, she had always thought she could stand to lose 5 pounds—“What girl doesn’t?,” she asks—even though at 5 foot 8 inches, tall and 130 pounds, she was slim. She had dieted a few times then, following the low-carb Atkins plan. This time around, however, her motivation to diet wasn’t just about dropping a dress size. It was also because she often felt uncomfortably full and bloated after eating.

“I became kind of fixated on not feeling so full,” she says. “Then it changed into not wanting to feel full at all.”

Before long, Beth was counting calories of whatever she put in her mouth and keeping her tally under 500 calories a day.

“I did everything I could to stay away from food,” she says.

The less she ate, the more she obsessed about food. She’d spend hours carefully planning what she would or wouldn’t eat each day—counting the number of peanuts or Cheerios she’d allow herself, while she staved off sharp hunger pangs with pickles, sugar-free jello and crushed ice. After starving herself for days or weeks at a time, she’d break down and binge.

“It was like my survival instinct took over and I’d binge on anything and everything I could find. Afterward, I’d feel so guilty—and panic about my weight—I’d go right back to restricting again,” says Beth, now 27. “It was hell.”

In between the starve-binge cycles, Beth managed to go through periods where she ate more “normally.” Then something stressful would happen—a breakup or exam period—and she’d return to restricting again.

During her junior year, Beth was hit with a bout of back pain. She went to the doctor, and, while there, happened to mention her trouble with bloating and “major stomach expansion.” The doctor ordered a few blood tests but didn’t indicate any specific concerns. A week later, she got a phone call from a nurse telling her it looked like she had celiac disease. In a matter of days, Beth underwent a small bowel biopsy and the diagnosis was confirmed.

“I didn’t know if having to go gluten free would help or hurt my eating issues,” she says. Guessing the latter, Beth decided to tell her doctor about her eating disorder. Until then, she had tried her best to keep her behavior under wraps.

“It’s really hard to admit the self-destructive things you do to yourself,” she says. “Maybe I didn’t explain it well because my doctor’s only response was to up my antidepressant dosage.” (Beth had taken a low-dose antidepressant since she was 16.) She filled the new prescription and gave the gluten-free diet a go—she wanted to get better—but it was a bumpy road.


“I felt deprived on the gluten-free diet,” she says. Even though she’d been severely restricting her calorie intake, she hadn’t faced the outright elimination of favorite foods. “Had I been able to eat a bite of something when I wanted it, like a gluten-filled doughnut or cookie, I think I could have escaped the starve-binge cycles more easily.” Instead, she struggled off and on with her eating disorder for the next four years.


Next: Linked Conditions

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