From: Ron Hoggan
Date: Sat, 25 May 1996 16:45:07 -0700 (MST)
Subject: anorexia & celiac

First, the list of references:

1. Lifshitz, "Nutritional Dwarfing" CURRENT PROBLEMS IN PEDIATRICS
     23(8): pages 322-336, Sept. 1993
2. Postel-Vinay, et al "Nutritional Status and Growth hormone-binding 
     Protein" HORMONE RESEARCH 44(4): pages 177-81, 1995
3. Korman, SH "Pica as a presenting symptom in childhood celiac disease"
     AMERICAN JOURNAL OF CLINICAL NUTRITION, 51(2): pages 139-141, Feb, 
     1990
4. Coghlan, & O'Morain "Adult lead toxicity and untreated celiac disease"
     JOURNAL OF THE ROYAL SOCIETY OF MEDICINE 81(10): page 612, Oct. 1988
5. Grenet, et. al. "Anorexic Forms of Celiac Syndromes" ANNALES de
     PEDIATRIE 19(6): pages 491-497, Jun/Jul, 1972
     This article is written in French, but a translation shouldn't be
     much problem. Let me know if you want one.
6. Wright, et. al. "Organic diseases mimicking atypical eating disorders"
     CLINICAL PEDIATRICS 29(6): pages 325-328, June, 1990
7. Barry, et. al. "Coeliac disease. The clinical Presentation" 
     CLINICS IN GASTROENTEROLOGY 3(1): pages 55-69, Jan, 1974
8. Hall, et. al. "Hyperphagia in intestinal disease" GUT 15(11): pages 858-
     861, Nov, 1974
9. Gent & Creamer "Faecal fats, appetite, and weight-loss in the coeliac
     syndrome" LANCET 1(551): pages 1063-1064, May 18, 1968
10 Ferrara & Fontana "Celiac disease and anorexia nervosa" NEW YORK STATE
     JOURNAL OF MEDICINE 66(8): pages 1000-1005, April 15, 1966
11 McNichol & Egan-Mitchell "Infancy celiac disease without diarrhea"
     PEDIATRICS 49(1): pages 85-91, Jan, 1972

     This is my selection of thirty some hits I got when I combined 
"celiac disease" and "eating disorders" on Medline. University of Calgary's
Medical library doesn't have many of these, but the ones I could get made
for interesting reading.

     It appears that from the mid sixties, there has been medical research 
that demonstrates a relationship between celiac disease and eating 
disorders. Hall & Creamer (8) demonstrated that overeating up to 5 times 
the normal caloric intake for their sizes and life-styles was the result of 
malabsorption. This should not be surprising, since these people were 
probably offsetting the losses associated with malabsorption. However, 
bulemic purging might well be anticipated if abdominal bloating were to 
become painful or otherwise problematic. Pica is sometimes the only 
presenting feature of celiac disease (3). This, too, should not be 
surprising, as a starving child attempts to meet its nutritional needs. 
What would be surprising is if this, too, did not result in bulemic 
purging. 

     Gent and Creamer, citing 56 cases, demonstrated that "weight-loss 
was related more to the appetite of the patient than to steatorrhoea." 
Even in infants, loss of appetite is a common presentation of celiac 
disease.(9) Barry, et. al. (7), in their discussion of childhood celiac 
disease, state the following: "In the well-established case the clinical 
presentation is fairly characteristic. The child is underweight and fails 
to thrive. He has a capricious appetite or is totally anorexic, quite 
unlike those children suffering from malabsorption due to fibrocystic 
disease." 

     I was only able to acquire the documents I have referred to in this 
post.