Patients with atopic dermatitis (AD) may have an increased risk for eating disorders, investigators reported in a study published in the Journal of the American Academy of Dermatology.

The retrospective study sought to determine whether patients with atopic dermatitis had an increased risk for eating disorders compared with the general population.

Data were obtained from the Finnish Care Register for Health Care database for all patients diagnosed with AD from 1987 to 2018. Eligible patients were younger than age 18 years at the time of their first AD diagnosis. The Finnish Population Register Center database was used to obtain data for a group of age- and sex-matched control individuals.


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A total of 70,584 patients with AD (mean [SD] age at onset of eating disorders,16.4 [4.19] years; 54.7% men) and 270,783 control participants (mean [SD] age at onset of eating disorders, 16.1 [3.62] years; 51.7% men) were included.

According to an adjusted model that controlled for birth year, sex, depression, anxiety, and food allergy, patients with AD had an increased odds of having any eating disorder compared with control individuals at ages 18 and 30 years. The strongest association between AD and eating disorders was found for bulimia nervosa (adjusted odds ratio [aOR] 2.31; 95% CI, 1.54-3.48), followed by binge-eating disorder (aOR 1.86; 95% CI, 1.29-2.68) at age 18 years.

“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,” stated the researchers.

The relationship between AD and mental disorder smay result from a negative cutaneous body image, stated the study authors, who added that autoreactivity also may have a role in the pathophysiology regarding the association between AD and eating disorders.

The investigators noted that their results need to be interpreted with caution, because statistical significance may be observed with minor differences that are not clinically relevant. Also, they could not consider all confounding factors such as participants’ socio-economic status.

“Our findings suggest that atopic dermatitis patients may be at particular risk of concomitant eating disorders,” the researchers concluded. “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.”

Disclosure: Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Kauppi S, Jokelainen J, Timonen M, Tasanen K, Huilaja L. Atopic dermatitis and the risk of eating disorders: a population-based cohort study. J Am Acad Dermatol. Published online October 22, 2021. doi:10.1016/j.jaad.2021.10.021