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.