Body image perception and emotional awareness in adults with celiac disease: A cross-sectional study

We aimed to investigate the relationship between alexithymia (a trait characterized by difficulty identifying and describing emotions) and body image (the perception and evaluation of one's own body) in adults with celiac disease (CD) compared to healthy controls. A cross-sectional study included 96 adults with CD (diagnosed via laboratory tests, endoscopy, or clinical assessment) and 96 healthy controls. Alexithymia, defined as difficulty identifying and expressing emotions, was evaluated alongside body image to assess its clinical relevance in adults with CD. All participants completed the Polish versions of the Toronto Alexithymia Scale-26 and Body Esteem Scale. CD patients showed higher total Toronto Alexithymia Scale-26 scores (indicating greater severity of alexithymic traits) (P = .006), particularly in difficulty identifying feelings and reduced daydreaming domains (P = .005 for both). Alexithymia was diagnosed in 26% of CD patients versus 8% of controls (P < .001). Male CD patients scored lower than healthy controls on Body Esteem Scale domains of physical attractiveness, body strength, and physical condition (P < .001, P = .010, P < .001, respectively). Alexithymia and body image disturbances are more pronounced in male CD patients than in healthy controls. Difficulty identifying feelings negatively affects body perception, highlighting the importance of psychosocial assessment in the management of CD. Addressing emotional awareness and body image could improve clinical care and quality of life in adults with CD.