Insights in altered eating behaviors in women with Ehlers-Danlos syndromes

BACKGROUND: Recent research on Ehlers-Danlos syndromes (EDS) highlights a high frequency of disordered eating behaviors and Body Mass Index (BMI), especially in the hypermobile subtype. These problems might be secondary to EDS symptoms and comorbidities such as gastrointestinal (GI) problems, food allergies and oral pain, but also to psychological factors. To test this hypothesis, we explored the above-mentioned somatic and psychological features and their connexions with eating behavioural outcomes and BMI. METHOD: Women with self-reported EDS (n = 121) completed an online survey assessing GI problems, food allergies, oral pain, somatosensory amplification, painful and fearful eating, eating avoidance and restriction, body satisfaction, and BMI. Path Analysis model was performed to examine the relationships among the variables. RESULTS: Significant relationships between GI problems and food allergies (B = 2.36, p = 0.035), fearful eating (B = 0.10, p = 0.043), painful eating (B = 0.02, p = 0.001) and somatosensory amplification (B = 1.01, p < 0.001) were observed. Also, positive relationships between painful and fearful eating (B = 0.76, p < 0.001), and fearful and avoidant eating (B = 0.78, p < 0.001). CONCLUSIONS: These results support the idea that certain somatic symptoms common in EDS would lead to fear and avoidant responses to food. Further research is needed to better understand the link and directionality between abnormal connective tissue and disordered eating behaviors. LEVEL OF EVIDENCE IV: Evidence obtained from observational-descriptive studies, such as case series, individual case reports, and descriptive cross-sectional studies.