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Nutrition and Eating Disorders in Alimentary Tract Diseases: Mechanisms, Challenges, and Open Questions

A Special Issue of Nutrients (ISSN 2072-6643) belonging to the section "Clinical Nutrition".

Deadline for manuscript submissions: 20 February 2027 | Viewed by 143

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Special Issue Information

Dear Colleagues,

The alimentary tract is the hub of reciprocal relationships, where diseases of the gut can provoke food restriction, fear of eating and maladaptive dietary patterns. However, eating disorders themselves also leave a measurable mark on oesophageal, gastric, intestinal and hepatic function. This overlap is common, frequently missed in routine gastroenterological practice and clinically consequential for nutritional status and quality of life. Several developments make a focused appraisal timely. Avoidant/restrictive food intake disorder is increasingly recognized in patients seen for dysphagia, functional dyspepsia, gastroparesis and disorders of gut–brain interaction, where symptom-driven avoidance can be mistaken for, or coexist with, organic disease. Conditions such as coeliac disease, inflammatory bowel disease and eosinophilic oesophagitis impose dietary constraints that may evolve into clinically significant disordered eating or orthorexia. At the same time, classical eating disorders such as anorexia nervosa, bulimia nervosa and binge-eating disorder generate a spectrum of gastrointestinal complications and nutritional deficits that gastroenterologists are well placed to detect but are not always equipped to manage. Important gaps remain in screening, diagnosis and care. Validated tools for identifying disordered eating in gastrointestinal populations are limited, the boundary between adaptive dietary management and pathological restriction is poorly defined and evidence on nutritional rehabilitation, refeeding safety and multidisciplinary pathways is fragmented across specialties. This Special Issue invites original research and reviews with clinically oriented perspectives addressing the intersection of eating disorders and alimentary tract diseases, with particular attention to nutritional assessment, mechanisms and management. Contributions that bridge gastroenterology, clinical nutrition and psychiatry are especially welcome.

Topics of interest include, but are not limited to:

  • Avoidant/restrictive food intake disorder in gastroenterological populations
  • Anorexia nervosa, bulimia nervosa and binge-eating disorder with gastrointestinal comorbidity
  • Disorders of gut–brain interaction and their overlap with disordered eating
  • Disordered eating and orthorexia in coeliac disease and other gluten-related disorders
  • Inflammatory bowel disease and maladaptive dietary patterns
  • Food avoidance in eosinophilic oesophagitis and food-related allergic disease
  • Restrictive eating in gastroparesis, functional dyspepsia and motility disorders
  • Eating pathology before and after bariatric and metabolic surgery
  • Gastrointestinal and hepatic complications of eating disorders
  • Refeeding syndrome, micronutrient deficiency and nutritional rehabilitation
  • The gut microbiota in eating disorders and its therapeutic implications
  • Screening instruments and diagnostic strategies for the gastroenterology setting
  • Multidisciplinary and nutritional management models

We look forward to your contribution.

Prof. Dr. Beata Kasztelan-Szczerbińska
Guest Editor

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Keywords

  • alimentary tract
  • eating disorders
  • anorexia nervosa
  • bulimia nervosa
  • binge-eating disorder
  • psychiatry
  • gastroenterology
  • nutrition

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Published Papers (1 paper)

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Review

34 pages, 1268 KB  
Review
Eating Disorders in the Context of Gastrointestinal Diseases—A Narrative Review
by Agnieszka Kopystecka, Beata Kasztelan-Szczerbinska and Halina Cichoz-Lach
Nutrients 2026, 18(18), 3045; https://doi.org/10.3390/nu18183045 (registering DOI) - 17 Sep 2026
Abstract
Background/Objectives: The clinical overlap between gastrointestinal (GI) conditions and psychiatric disorders represents a challenge in clinical practice. Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, binge eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID), may co-occur with gastrointestinal (GI) diseases and complicate [...] Read more.
Background/Objectives: The clinical overlap between gastrointestinal (GI) conditions and psychiatric disorders represents a challenge in clinical practice. Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, binge eating disorder (BED), and avoidant/restrictive food intake disorder (ARFID), may co-occur with gastrointestinal (GI) diseases and complicate their management. Orthorexia nervosa is a proposed and emerging construct characterized by pathological preoccupation with healthy eating and rigid dietary practices. This narrative review aims to summarize current evidence regarding eating disorder symptomatology, ARFID screening and diagnosis, orthorexic symptomatology, pathophysiological mechanisms, and diagnostic challenges across gastrointestinal diseases, with particular attention to inflammatory bowel disease (IBD), disorders of gut–brain interaction (DGBIs), celiac disease, eosinophilic esophagitis, upper gastrointestinal motility disorders, and the potential role of the gut microbiota. Methods: The review was structured in accordance with the SANRA guidelines. A structured literature search was conducted primarily in PubMed, with Scopus and Google Scholar used as supplementary sources for identifying additional relevant publications through citation tracking and examination of reference networks, for articles published from 2011 through early 2026. Results: The available literature indicates an association between GI disorders and disordered eating, with potentially bidirectional relationships involving symptom burden, dietary restriction, psychological factors, and gut–brain signaling. Chronic GI symptoms often necessitate dietary modifications, which can inadvertently trigger or mask pathological restrictive eating behaviors. Diagnosing ARFID and orthorexia in these cohorts is particularly challenging due to overlapping somatic symptoms. Primary EDs are also associated with gastrointestinal symptoms and alterations in the gut microbiome; however, human evidence remains predominantly observational, and the temporal and causal relationships between dysbiosis, nutritional restriction, inflammation, and gastrointestinal dysfunction remain uncertain. Conclusions: The convergence of EDs and GI conditions requires heightened clinical vigilance. Distinguishing between necessary, symptom-driven dietary restrictions and pathological eating behaviors is crucial. Implementing an integrated, multidisciplinary care model-involving gastroenterologists, psychiatrists, and dietitians-is essential to improve diagnostic accuracy and patient outcomes. Full article
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