Eating behaviors and mental health among celiac patients, case-control study.

Abstract

Background: Celiac disease (CD) is an autoimmune disorder affecting genetically predisposed individuals, causing abnormal immune responses against gluten-containing grains. Celiac disease patients are at risk for health-related problems that affect their nutrition status, mental health and eating behavior. The focus of this study was on mental health aspects, including anxiety, stress and depression as well as eating behaviors among celiac disease patients in Palestine.

Methods: This case-control study compared eating behaviors and psychological status among 226 celiac disease patients and healthy controls. Data was collected using an online questionnaire administrated via Google forms. We used the Eating Behaviors Reference for Adults to assess eating behaviors and the Depression Anxiety and Stress Scale (DASS 21) to assess psychological status. We measured nutritional status using variables such as body mass index (BMI), unintentional weight loss and eating that had stopped or nearly stopped for more than five days.

Results: The study indicated that the case group had a higher mean psychological level as compared to the control group; the mean depression score for the case was 12.94 ± 5.30 for the control (11.35 ± 3.95), p < 0.05. Anxiety levels were higher in the case group (13.72 ± 5.38) compared to the control group (12.25 ± 4.09) (p < 0.05). The case had a higher stress level (15.83 ± 5.58) than the control group (14.23 ± 4.24) (p < 0.05). Results highlighted that mental health association with eating behaviors was found to be significant in the case group, as depression, anxiety and stress were significantly associated with satisfaction responses (r = -.319) (p value ≤ 0.01), (r = .439) (p value ≤ 0.05) and (r = .381) (p value ≤ 0.01) but not in hunger, emotional eating or picky eating. Additionally, with stress was found to be more significant in slow eating (r = .186) (p value ≤ 0.05).

Conclusion: Celiac disease impacts mental health, including depression, stress and anxiety. It also affects eating behaviors such as slow eating, enjoyment and satiety responsiveness. In celiac disease patients, mental health influences eating behaviors such as slow eating and satiety responses.