Gram Research analysis of a 2026 Swedish study of 37,853 people with celiac disease found they had a 39% higher risk of developing an eating disorder than matched peers. The extra risk was highest in the first five years after diagnosis. Biological relatives showed no increased risk, and the absolute risk remained low.
A large Swedish study followed people with celiac disease, an autoimmune condition where gluten damages the gut, to see whether they were more likely to develop eating disorders. According to research reviewed by Gram, people with celiac disease had about a 39% higher risk of an eating disorder than matched people without the condition. The extra risk was strongest in the first five years after diagnosis. The researchers did not find higher risk among the biological parents, brothers and sisters, or children of people with celiac disease, which suggests that shared genes alone may not explain the link. The overall absolute risk remained low. The authors suggest that doctors keep an eye out for disordered eating in people newly diagnosed with celiac disease, particularly as they adjust to a strict gluten-free diet.
Key Statistics
A 2026 nationwide cohort study of 37,853 people with celiac disease in Sweden found a 39% higher risk of eating disorders compared with matched people from the general population (adjusted hazard ratio 1.39).
Over 20 years of follow-up, the 2026 Swedish study estimated about one extra eating disorder case for every 222 people with celiac disease.
In the same 2026 study, parents, full siblings, and children of people with celiac disease showed no significantly higher risk of eating disorders.
The Quick Take
- What they studied: Do people with celiac disease develop eating disorders more often than other people, and does this extra risk also show up in their close family members?
- Who participated: The study included 37,853 people in Sweden diagnosed with celiac disease between 2002 and 2023, and about 185,000 matched people from the general population for comparison. About 63% of the celiac group were women, and the median age at diagnosis was about 29 years. Researchers also looked at parents, siblings, and children of both groups.
- Key finding: Over an average of about 11 years of follow-up, people with celiac disease had a 39% higher risk of an eating disorder than the comparison group (hazard ratio 1.39). The extra risk was highest in the first five years. Over 20 years, the researchers estimated about one extra eating disorder case for every 222 people with celiac disease.
- What it means for you: If you or someone you love has celiac disease, it may help to watch for changes in eating habits, body image, or food anxiety, especially in the first few years after diagnosis. Eating disorders are still uncommon, so this is a reason for awareness, not alarm. Talk with a doctor if you notice concerns.
The Research Details
This was a large population-based cohort study, meaning researchers followed a group of people over time to see who later developed a particular health problem. The data came from Swedish national health records, which cover nearly everyone living in the country. Patients were included if a biopsy of their small intestine confirmed celiac disease. Biopsy results were collected from all 28 histopathology departments in Sweden, which helped make sure that diagnoses were consistent.
Each person with celiac disease was matched with up to five people from the general population who were similar in age, sex, and other factors. Researchers then tracked both groups for eating disorder diagnoses, starting at age 6 and continuing through 2023. They also tracked biological parents, full siblings, and children of each person, which allowed them to check whether any extra risk ran in families.
To measure risk, the team used statistical models that compare how quickly the two groups developed eating disorders over time. They also ran extra checks to see whether errors in the records or other differences between groups could explain the results. Most of these checks gave similar answers to the main analysis.
Because the study followed nearly all people with celiac disease in a whole country, it reduces the chance that the results reflect only a small or unusual group. Comparing people with celiac disease to matched peers, and then looking at their relatives, helps separate effects of the disease and its treatment from effects of shared family genes. Following people over many years also shows when the extra risk is highest, which is useful for knowing when to pay closer attention.
This study has several strengths: a very large sample, national health records, a long follow-up period (about 11 years on average), and biopsy-confirmed diagnoses. Because it is observational, it can show that two things are linked but cannot prove that celiac disease directly causes eating disorders. Health records may also miss mild cases that never reached a doctor, and the study relied on diagnosis codes rather than direct questions to participants. The authors ran several sensitivity checks, and their main findings held up across them.
What the Results Show
During the study, 485 people with celiac disease (about 1.3%) and 1,578 people in the comparison group (about 0.9%) received a diagnosis of an eating disorder. After adjusting for other factors, people with celiac disease had a 39% higher risk of an eating disorder over time (adjusted hazard ratio 1.39, with a 95% confidence range of 1.27 to 1.53). A hazard ratio above 1 means a higher rate of the outcome, so this result points to a real but moderate increase in risk.
The extra risk was not spread evenly over time. It was most noticeable during the first five years after diagnosis. This timing suggests that the period right after diagnosis, when people are learning to manage a strict gluten-free diet and adjusting to a new health condition, may be especially important. The researchers did not find a clear explanation for why the risk fades later, and more research would be needed to understand this pattern.
Although the increase was statistically meaningful, the total number of affected people remained small. The researchers estimated that over 20 years, there would be about one extra eating disorder case for every 222 people with celiac disease. In other words, most people with celiac disease will never develop an eating disorder, but the increased risk is still worth knowing about.
The researchers also looked at family members. Parents, full siblings, and children of people with celiac disease did not show a higher risk of eating disorders compared with families of people in the general population. This suggests the increased risk is more closely tied to having celiac disease itself than to inherited factors shared within families.
Among the biological relatives of people with celiac disease, the estimated risk was 0.82 for parents (confidence range 0.61 to 1.12), 1.11 for full siblings (0.99 to 1.24), and 1.05 for children (0.92 to 1.20). Because all of these ranges include 1, which means no difference, none of these results shows a clear increase or decrease in risk. The results also held up under additional checks designed to account for errors in the health records and for other factors that might have influenced the findings. Together, these checks make it less likely that the main result came from a quirk in the data.
The authors note that earlier studies had suggested people with celiac disease might face a higher risk of eating disorders, and this large national study supports that idea with more recent and more complete data. Researchers have proposed a few possible explanations, including genetic susceptibility that affects both conditions and the psychological strain of managing a restrictive diet for life. This study’s family results make the genetic explanation less likely as the main cause, which points more toward factors connected to living with the disease. Previous work has been limited by smaller groups or shorter follow-up, so this study adds a more detailed picture.
The study depended on diagnosis codes recorded in national health registers, so people who had mild symptoms and never saw a doctor for an eating disorder would not be counted. Because the study was observational, it cannot prove cause and effect, and other unmeasured differences between the two groups could play a role. The study was conducted in Sweden, so results may not apply exactly to other countries with different healthcare systems, diets, or cultural attitudes toward food and body image. The authors also could not see details such as how strictly each person followed a gluten-free diet, which might be an important factor.
The Bottom Line
Research shows that people with celiac disease have a moderately higher risk of eating disorders, especially in the first five years after diagnosis (high confidence in the association from this large national study). Doctors may reasonably screen for disordered eating during follow-up visits for people newly diagnosed with celiac disease. Because the absolute risk is low, this should be a routine check, not a cause for alarm. Whether specific interventions reduce this risk is not yet known (low confidence).
People recently diagnosed with celiac disease, their families, and the clinicians who care for them should pay the most attention to these findings. Dietitians and mental health professionals who work with people on gluten-free diets may also find the results useful. People without celiac disease, or people who have been living with the condition for many years, may find the results less directly relevant, though the study does not show higher risk for their relatives.
The highest risk appeared during the first five years after diagnosis, so that is the period when extra attention matters most. Over longer periods, the risk per person remained small. Anyone concerned about changes in eating habits or body image should not wait for a set timeline and should talk with a healthcare provider as soon as concerns arise.
Frequently Asked Questions
Does celiac disease increase the risk of eating disorders?
A 2026 Swedish study of 37,853 people with celiac disease found they had about a 39% higher risk of eating disorders than matched peers. The increase was most noticeable in the first five years after diagnosis, though the overall absolute risk remained low.
Are family members of people with celiac disease also at higher risk for eating disorders?
The same Swedish study found no significant increase in eating disorder risk among parents, full siblings, or children of people with celiac disease. This suggests the extra risk is more closely linked to living with the condition than to shared family genes.
When is the risk of an eating disorder highest for people with celiac disease?
Researchers found the highest risk during the first five years after a celiac disease diagnosis. This period often involves adjusting to a strict gluten-free diet, so doctors may watch closely for disordered eating during early follow-up visits.
How common are eating disorders in people with celiac disease over the long term?
Over 20 years, the researchers estimated about one extra eating disorder case for every 222 people with celiac disease. Most people with the condition will not develop an eating disorder, but the extra risk is worth knowing about.
Want to Apply This Research?
- Track a weekly check-in with three simple questions: how often you felt anxious about food, how often you skipped or restricted meals beyond what your diet requires, and how comfortable you felt eating in social settings, each rated from 1 (never) to 5 (almost always). A rising score over several weeks can be a useful signal to talk with a clinician.
- Set up a regular meal rhythm with consistent times for eating, and log meals in the app without counting calories or judging portions. Pair gluten-free meal planning with a nutrition professional so that the diet is balanced and flexible rather than restrictive. Use the app to note any situations that trigger stress about food so you can discuss them with your care team.
- Plan a brief monthly check-in during the first two to five years after diagnosis, then move to a quarterly check-in if things feel stable. Review trends in your weekly scores and meal logs together with your doctor or dietitian at scheduled visits. If your scores remain stable over a year, the app can shift to occasional reminders to keep your awareness up.
This article summarizes an observational study and is for general information only. It is not medical advice and does not replace guidance from a doctor, registered dietitian, or mental health professional. If you have celiac disease or concerns about eating behaviors, please speak with a qualified healthcare provider. Anyone experiencing an eating disorder or thoughts of self-harm should seek immediate professional help.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.