Ansiedade e depressão associadas a desordens alimentares e dispepsias e o manejo dietético

Anxiety and depression are frequent comorbidities in eating disorders (ED)—such as anorexia nervosa, bulimia nervosa, and binge eating disorder—and in dyspepsia, especially functional dyspepsia (FD). The presence of these conditions worsens symptoms, increases care costs, and negatively impacts outcomes, including mortality in ED. A recent synthesis suggests that 55–95% of individuals with ED will develop a psychiatric disorder during their lifetime, and updated guidelines emphasize disorder-specific psychotherapy as the central axis of care. In FD, systematic reviews show high prevalence of anxiety and depression, particularly in refractory cases, as well as bidirectional relationships mediated by the gut–brain–microbiota axis. This clinical scenario imposes challenges on dietary management: in ED, nutritional rehabilitation must occur in integration with psychotherapeutic treatment; in FD, evidence supports targeted dietary interventions (e.g., Mediterranean-type patterns, selective reduction of dietary triggers, and, in selected cases, low-FODMAP strategies), always weighing the risks of excessive restriction in individuals vulnerable to ED. This article integrates findings from reviews, meta-analyses, and guidelines published since 2020, and proposes practical principles for interprofessional dietary management aimed at minimizing gastrointestinal symptoms, reducing psychological distress, and promoting safe and sustained adherence