Patients with atopic dermatitis (AD) are more likely to have eating disorders than patients without AD, and dermatologists may be in a position to identify this risk at an early stage. That’s according to a research poster presented at the annual meeting of the American Academy of Dermatology and published in the October/November issue of The Chronicle of Skin & Allergy.
This cross-sectional study of U.S. adults compared the risk of eating disorders in patients with AD and patients without AD using data from the All of US Research Program in the U.S., according to senior author Dr. Jeffrey M. Cohen.
“We know that AD is associated with mental health problems such as anxiety and depression,” Dr. Cohen said, noting patients with AD can have struggles with body image.
“Eating disorders represent additional important mental health issues, but there is very limited evidence on whether AD may be a risk factor for eating disorders.” Dr. Cohen is Director, Psoriasis Treatment Program, Assistant Professor of Dermatology and Biomedical Informatics and Data Science at Yale School of Medicine, New Haven, Conn.
Dr. Cohen and his co-investigators had access to information on 266,612 subjects, 12,603 of whom had AD with a mean age of 58 years, and 254,009 of whom did not have AD with a mean age of 55 years. Investigators found individuals with AD were significantly more likely than those without the condition to have been diagnosed with all eating disorders that were tested: anorexia nervosa (0.2% vs. 0.1%, p<0.001), bulimia nervosa, (0.2% vs. 0.1%, p<0.001), bulimia eating disorder (0.3% vs. 0.1%, p<0.001), eating disorder unspecified (1.4% vs. 0.4%, p<0.001), and other specified eating disorder (0.4% vs. 0.2%, p<0.001).
“As with all epidemiologic studies, we were able to show an association,” said Dr. Cohen. “This is important and relevant, but it does not allow us to comment on causation and also does not produce evidence on why the association exists.”
Eating disorders are more common in females than males, and the investigators controlled for sex in their analysis. “All of our adjusted models included sex, allowing us to use a statistical technique to try to reduce the impact of sex on our results,” said Dr. Cohen.
The study results suggest that dermatologists can take a more active role in the mental health of their patients with AD, said Dr. Cohen.
“The most important takeaway is to be aware that patients with AD may have a higher likelihood of developing an eating disorder than those without AD,” said Dr. Cohen. “This places dermatologists in an important position to be able to identify eating disorders early on to help patients access essential care that may be lifesaving. For many AD patients, the dermatologist is the physician they see most often, which positions dermatologists to play a key role in the overall health of their patients.”
With files from Chronicle Correspondent Louise Gagnon
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