Provider-Prescribed Restrictive Diets in Patients With Eating Disorders Presenting for Gastroenterology Care
Abstract
Introduction: Despite considerable evidence and patient demand, restrictive diets for gastrointestinal (GI) disorders may be harmful in those with comorbid eating disorders (EDs). We identified the frequency and characteristics of provider-recommended restrictive diets among those with EDs seeking GI care.
Methods: Using a preexisting cohort of patients who had a GI encounter from 2010 to 2020 with a GI diagnosis and ED diagnosis (either diagnosed before or after initial GI encounter), we conducted a retrospective analysis of restrictive diet prescriptions within 12 months of initial GI consult as well as diet type, provider subspecialty, and types of ED and GI diagnoses.
Results: From a cohort of 610 patients, we found 285 patients meeting our inclusion criteria; 50 (17.5%) were prescribed restrictive diets within 12 months of their GI consult by GI providers. Disorders of gut-brain interaction were the most common GI diagnoses overall (n = 169, 59.3%). Of those with a pre-existing ED (n = 188), 30 (16.0%) were prescribed a restrictive diet, and of those with a subsequently diagnosed ED (n = 97), 20 (20.6%) were prescribed a restrictive diet. Among patients with preexisting EDs, 69 (36.7%) were not in remission at the time of consultation. Of those with preexisting EDs who were prescribed a restrictive diet, 17/30 (57.7%) were not in remission.
Conclusion: We found that 16% of patients with an ED history were prescribed a restrictive diet by their gastroenterologist,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 610 participants or records.
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