Atopic dermatitis, the most common form of eczema, doesn’t just cause rough, itchy, rash-like patches on the skin: A new study suggests it may also increase a person’s risk of disordered eating.
“The emotional toll of eczema is significant,” says the senior study author, Jeffrey Cohen, MD, a dermatologist, an assistant professor, and the director of the psoriasis treatment program at the Yale School of Medicine in New Haven, Connecticut.
Atopic dermatitis may harm mental health because it can flare up at any time, is visible to others, and can cause intense itchiness that makes it hard to sleep or keep up with daily routines at school or work, Dr. Cohen adds.
The condition can also negatively impact friendships and intimate relationships, eroding social support systems that can be beneficial for mental health.
While atopic dermatitis has long been linked to poor mental health and conditions like anxiety and depression, less is known about its relationship to eating disorders.
Atopic Dermatitis Doubled the Risk of Anorexia and Bulimia in the Study
For the new study, researchers examined data on about 12,600 people with atopic dermatitis and 254,000 individuals without this condition.
Overall, people with atopic dermatitis were more than twice as likely to develop anorexia nervosa or bulimia nervosa than individuals without atopic dermatitis, the researchers reported in the British Journal of Dermatology. Anorexia nervosa is an eating disorder that involves severe food restriction, while bulimia nervosa involves bingeing and then purging food.
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Atopic dermatitis was also tied to a more than tripled risk of binge eating disorder, which involves consuming large quantities of food without purging, the study found.
Most people with atopic dermatitis in the study who had an eating disorder also had mood disorders like anxiety or depression.
Why Is Atopic Dermatitis Linked to Eating Disorders?
The study wasn’t designed to prove whether or how atopic dermatitis might directly cause eating disorders, or whether the reverse might be true.
“There is a complex interplay at work with atopic dermatitis and we need more information,” says Bruce Brod, MD, a clinical professor of dermatology and the director of the occupational and contact dermatitis clinic at the University of Pennsylvania Perelman School of Medicine in Philadelphia.
“The potential connection is not surprising, as atopic dermatitis has been associated with other comorbidities, such as depression, anxiety, obesity, and elevated lipids,” says Dr. Brod, who wasn’t involved in the new study. “The question is: What came first, the chicken or the egg?”
Treating Atopic Dermatitis Improves Mental Health
Even if the exact nature of the relationship between atopic dermatitis and eating disorders isn’t clear, the study findings still offer a sliver of hope to people who are struggling, Brod says. It’s possible that effectively managing atopic dermatitis might help reduce mental health symptoms that can play a role in problematic eating behaviors.
“I have seen the physical and mental toll atopic dermatitis has on my own patients, as well as the improvement in mental well-being when my patients achieve improvement of their disease,” Brod says.
It’s too soon to say for sure, however, whether eating disorders might be prevented or treated by managing atopic dermatitis in people who live with both conditions, Cohen says.
“Controlling eczema with effective treatment can certainly improve mental health,” Cohen says. “However, much more work needs to be done to understand whether treatment of eczema can prevent subsequent mood or eating disorders.”
