SYSTEMATIC REVIEW OF THE INCIDENCE AND/OR PREVALENCE OF EATING DISORDERS IN INDIVIDUALS WITH FOOD ALLERGIES.

Abstract

Chronic diseases involving strict dietary adherence have been associated with an increased risk of eating disorders. This is the first systematic review investigating the rate of eating disorders among individuals with food allergies. To report the incidence, prevalence, and types of eating disorders in individuals with food allergies. Following PRISMA guidelines, we searched four databases for studies published to January 2022 that reported the prevalence or incidence of eating disorders in samples with IgE or non-IgE-mediated allergy. Risk of bias was assessed and evidence qualitatively synthesised. From 1180 papers identified, nine met inclusion criteria. There were 4161 adult and paediatric participants with IgE-mediated food allergies or eosinophilic esophagitis (EoE). Avoidant Restrictive Food Intake Disorder (ARFID) or anorexia/bulimia nervosa were the main eating disorders identified. The prevalence of eating disorders in samples with food allergy ranged from 0.8%-62.9%. Among studies investigating IgE-mediated food allergy (n=6), the prevalence of anorexia and/or bulimia ranged from 17.6-61%, ARFID was 62.9% and unspecified eating disorders was 0.8-6%. Among samples with EoE (n=3), ARFID prevalence ranged from 4.5-51%. Most studies were limited by small sample size, possible selection bias, and lack of diagnostic eating disorders tools validated for food allergic populations. Eating disorders appear prevalent in individuals with food allergy, however prevalence estimates varied widely. Large studies with healthy control groups and validated measures to identify eating disorders in individuals with food allergy are needed to accurately determine the prevalence of eating disorders.