Article open access publication

Eating Disorders, Autoimmune, and Autoinflammatory Disease

Pediatrics, American Academy of Pediatrics (AAP), ISSN 1098-4275

Volume 140, 6, 2017

DOI:10.1542/peds.2016-2089, Dimensions: pub.1092619151, PMC: PMC5703777, PMID: 29122972,



  1. (1) Departments of Psychiatry and
  2. (2) National Centre for Register-Based Research,
  3. (3) The Lundbeck Foundation Initiative for Integrative Psychiatric Research, and
  4. (4) University of Turin, grid.7605.4
  5. (5) Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen, Denmark;
  6. (6) University of Copenhagen, grid.5254.6, KU
  7. (7) Duke University, grid.26009.3d
  8. (8) Aarhus University, grid.7048.b, AU
  9. (9) Karolinska Institute, grid.4714.6
  10. (10) University of North Carolina at Chapel Hill, grid.10698.36


OBJECTIVES: Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands. METHODS: In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930‚ÄČ977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. RESULTS: We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). CONCLUSIONS: Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets.


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Times Cited: 23

Field Citation Ratio (FCR): 9.67

Relative Citation ratio (RCR): 2.57

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Green, Published