NUTRITION HOTLINE: Acid Reflux

Q: My friend's daughter may have developed anorexia nervosa because of acid reflux. She insists that she does not have any of the emotional or psychological issues of anorexia, she is just afraid to eat. What is acid reflux? Can it cause an eating disorder?

A: Acid reflux (also called gastroesophageal reflux) occurs when the acidic contents of the stomach enter into the esophagus, causing burning, pain, and/or pressure in the chest. The symptoms frequently occur during or right after eating, causing food consumption to be associated with pain. There are many case reports in the literature of children developing anorexia nervosa from gastroesophageal reflux. Your friend's daughter may have atypical anorexia, which means she has all of the symptoms of anorexia except for fear of weight gain and body distortion. However, she may also have a food phobia condition called phagophobia This condition involves a "phobic food avoidance" to avoid pain and is not associated with true anorexia nervosa.

I have seen cases in my practice where children have had gastrointestinal conditions that have led to either anorexia nervosa or atypical anorexia. The difference for those children who develop the full spectrum may be the presence of the gene for anorexia, where the dietary restriction from pain triggers the onset of the other anorexic symptoms.

In either case the gastroesophageal symptoms must be treated along with the anorexia in order for the child to return to normal health.