Coeliac Disease: Eating Attitudes and Behaviours. Rosie Satherley, Professor Suzanne Higgs, Dr. Ruth Howard University of Birmingham

Transcription

1 Coeliac Disease: Eating Attitudes and Behaviours Rosie Satherley, Professor Suzanne Higgs, Dr. Ruth Howard University of Birmingham

2 Who am I? University of Birmingham, UK Adults with coeliac disease Kings College London, UK Children with long-term conditions

3 Psychology and Eating in Children with Coeliac Disease Concerns and anxieties around food are normal in people with coeliac disease However, for some, this can result in: Fear Isolation Anxiety Depression Impaired Quality of Life

4 My Research Eating Attitudes and Behaviours in Adults with Coeliac Disease All this research has been explored in adults In the future, we hope to explore this in children

5 Understanding the Link: Risk Factors Diagnosis of a long-term condition Weight changes after diagnosis Gastrointestinal symptoms Label reading and food caution Restrictive gluten-free diet

6 Understanding the Link: Risk Factors An eating disorder already leaves people concerned about what they eat, coeliac disease adds a new fear of eating something with gluten in it

7 Understanding the Link: Research How common is disordered eating in coeliac disease? What factors are associated with disordered eating in coeliac disease? Questionnaires Computer tasks Food taste tests Talking to people like you

8 Coeliac Disease 15-21% Understanding the Link: How Common? Long-Term Conditions 8-20% Healthy Controls 2-3%

9 Understanding the Link: What Factors are Linked with Disordered Eating? Factors Common to all Long Term Conditions Being diagnosed with a long-term condition is a difficult time Depression, Anxiety, Stress Coeliac Disease Specific Factors Sometimes coeliac disease is hard to manage Dietary-management, gastrointestinal symptoms

10 Understanding the Link: Food Concerns Not all people with disordered eating do this to lose weight Some people with coeliac disease might develop an extreme anxiety and vigilance around food Food is the enemy. I don t let other people eat near me. I am scared of the crumbs.

11 Understanding the Link: Types of Disordered Eating 1. Psychological distress 2. Concerns around cross-contamination 3. Management of the gluten-free diet

12 Example: Psychological Distress Sarah had lost interest in the things she used to enjoy and felt isolated. She hated following her strict, gluten-free diet. Whenever Sarah saw gluten-free food, she would collect it and eat it all in one go. She used this food to make herself feel better.

13 Example: Concerns around Cross- Contamination Jake felt nauseous and tired before his coeliac disease diagnosis. His gluten-free diet makes him feel better. Jake is worried about experiencing these symptoms again. He only likes to eat food he has made in his own kitchen. This has stopped him from going to his friends birthday.

14 Example: Gluten-Free Diet Management Ella was underweight before she was diagnosed. She put on some weight when she started her gluten-free diet because her body was recovering. Ella didn t like this weight change. She started eating gluten, to try and make herself underweight again.

15 When does it become Disordered Eating? Not everyone with coeliac disease will develop disordered eating Sometimes people will coeliac disease have to alter their eating patterns to stick to their gluten-free diet This may become a concern when the following happen: Fear Isolation Anxiety Depression Impaired Quality of Life Malnutrition Poor gluten-free diet management

16 What about Children with Coeliac Disease? Some limited evidence for disordered eating in children and adolescents Greater risk of eating disorder diagnosis (Butwicka et al., 2017) Associated with poor management of gluten-free diet and psychological distress (Karwautz et al., 2008; Wagner et al., 2015)

17 How can we Help: Tips and Tricks Plan and prepare Carry food Education around cross contamination Confidence Support from family and friends If concerned about yourself or your child, please seek support from your healthcare professional

18 Despite having Coeliac Disease We would like you to: Have a well-balanced diet Feel confident asking for gluten-free foods Not feel distressed Have a good quality of life The majority of people with coeliac disease will have a healthy, well-balanced diet

19 Thank you Any Questions?