Provider-Prescribed Restrictive Diets in Patients With Eating Disorders Presenting for Gastroenterology Care

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.

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.

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.

We found that 16% of patients with an ED history were prescribed a restrictive diet by their gastroenterologist, including those not in remission. Further research is needed on the potential risk of restrictive diets in facilitating ED behavior.