Eating Disorders and Vegetarianism If you accept the premise that 20-30% of the general population has the genetic predisposition for celiac disease, but only a tiny fraction of that group ever develop it(5), and if you accept the assumption that the vegetarian's diet is likely to have a greater gluten (proteins from wheat, rye, and barley) content, then you may be interested in the hypothesis that I now put forward. Increased dietary consumption of gluten increases the risk of presentation of symptoms of celiac disease, among those who are genetically susceptible. Among those with celiac disease, the connection with eating disorders is well known, and well documented.(1,2,3,4). An examination of some of the possible dynamics at work in cd may offer insight into the broader realm of eating disorders. Since one primary, defining characteristic of celiac disease is damage to the microvilli in the intestinal lining, and since malabsorption of vitamins and minerals is well known in celiac disease, it should not be surprising that some celiacs are well known for demonstrating pica. It is a natural reaction for most beings to attempt to consume substances that may meet their dietary deficiencies. Some celiacs are also well known for their excessive eating, and failure to gain weight. Another group of celiacs refuse to eat. Perhaps that group is aware that eating makes them feel sick, so they avoid it. There are some rare presentations of obesity in celiac disease, as well. One woman, diagnosed by Dr. Joe Murray at the University of Iowa, weighed 388 pounds at diagnosis. Dr. Murray explains her situation as an overcompensation for malabsorption. I want to offer a two faceted, alternative explanation, which may apply to a large segment of the population. Perhaps all of those with a genetic predisposition for cd, experience minute levels of damage to the microvilli in the brush border of the intestinal lining. If this minute damage interferes with the absorption of essential fatty acids, and/or other micronutrients, then a deficiency would ensue. The natural response would be to eat more.... to feel hunger, in spite of having consumed sufficient calories. Caloric intake may be huge, and fats may continue to be stored, and still, due to reduced absorptive capacity, the EFAs may be inadequate. There may also be some dietary insufficiency regarding EFAs. That might be rooted in the common medical recommendation that obese people go on a reduced fat diet. The likely result is an increased intake of carbohydrates. If my sense of the underlying problem, caloric adequacy combined with EFA deficiency (due to malabsorption at the microvilli) is accurate, then this is exactly the wrong prescription. So the person who is obese, is condemned by current medical practice, to a life of ever deepening depression, autoimmune diseases, and increasing obesity. And at the end of the day, when these folks drop dead from heart attacks, strokes, or some similar disaster, the self-righteous doctors and lay people just know that the problem was a lack of willpower. I watched my mom steadily gain weight for 35 years. I watched her exercise more will power than most of us are capable of. Still, she could not resist her compulsive eating. I have seen her take something from the freezer, and chew on it, while granting that she had just eaten a very full meal, and was quite full. In Dec. 1994, I was diagnosed with celiac disease. As a first-degree relative, my mom should have, according to the published experts in this area, tested also. Her doctor refused. He laughed at the idea. Through persistence, and a pervasive faith in her son, mom finally (after 4 months of negotiation) swayed her doctor to do the anti-gliadin antibody blood test. She had been on a very reduced gluten diet for the past year, and still, her antibody levels were elevated. She never sought a definitive diagnosis. She has been gluten-free for the past 7 months. Her arthritis is improved (although other therapies are ongoing), but the most significant difference she sees is the cessation of her compulsive eating. The meals she eats now are quite small. Except during the Christmas season, she hasn't bothered with snacking. She has no problem saying no, now. Her weakness was never will power. She was battling an instinct so basic, that only a saint could have resisted. That, I think, is the story behind much of North American obesity. References: 1. Ferrara, et. al. "Celiac disease and anorexia nervosa" _New York State Journal of Medicine_ 1966; 66(8): 1000-1005 2. Gent & Creamer "Faecal fats, appetite, and weight loss in the coeliac syndrome" _Lancet_ 1968; 1(551): 1063-1064 3. Wright, et. al. "Organic diseases mimicking atypical eating disorders" _Clinical Pediatrics_ 1990; 29(6): 325-328 4. Grenet, et. al. "Anorexic forms of celiac syndromes" _Annales de Pediatrie_ 1972; 19(6): 491-497 5. Hoggan, R "Considering Wheat, Rye, and Barley Proteins as Aids to Carcinogens" _Medical Hypotheses_ In Press.