Dietary Restrictions in Celiac Disease: Differential Diagnosis Between Eating Disorders and Disordered Eating.

Celiac disease requires strict adherence to a gluten-free diet, which can significantly affect eating behaviors and increase the risk of eating disorders and disordered eating. Although clinically challenging, distinguishing between these conditions is essential in the context of prescribed dietary restrictions. In this literature review, we identified an increased risk of eating disorders, particularly anorexia nervosa, in individuals with celiac disease, as well as disordered eating behaviors, including excessive restriction, food-related anxiety, and social avoidance, all of which are associated with reduced quality of life. However, current assessment tools do not adequately distinguish between pathological eating behaviors and appropriate adherence to a prescribed therapeutic diet. Although a multidisciplinary approach that includes nutritional and mental health support is recommended, evidence-based therapeutic strategies specific to celiac disease are still lacking. Overall, eating disorders in celiac disease are common and clinically relevant, highlighting the need to improve their detection and develop more appropriate diagnostic tools for both clinical practice and research.