A new study by researchers at the Yale School of Medicine and Yale School of Public Health finds a significant association between eczema (atopic dermatitis) and eating disorders. The findings highlight the intricate relationship between dermatological conditions and mental health, the authors said.
While previous research has attempted to explore the link between atopic dermatitis and various psychiatric conditions, data exploring eczema’s relationship with eating disorders is limited.
The current study — published March 11 in the British Journal of Dermatology — analyzed data from more than 250,000 electronic medical records of patients participating in the All of Us Research Program. The program is an ambitious effort by the National Institutes of Health to enroll over one million American adults from various demographic and socioeconomic backgrounds to create one of the most diverse health databases in history.
The Yale study is believed to be one of the first to present significant evidence that individuals with eczema are at increased risk of certain eating disorders, particularly anorexia nervosa, bulimia nervosa, and binge eating disorder.
Early detection of eating disorders is essential, and understanding that those with eczema are at higher risk may help with early diagnosis.
Dr. Jeffrey M. Cohen
Atopic dermatitis or eczema is a chronic inflammatory skin condition that affects approximately 10% of Americans. It is characterized by inflammation, redness, and dry and itchy patches of skin that can cause itching and sleeping problems.
The Yale study found that individuals with eczema are three times more likely to experience binge eating disorder and twice as likely to experience anorexia nervosa or bulimia nervosa.
The study suggests that eating disorders may develop as a coping mechanism for individuals struggling with feelings of depression and anxiety due to their eczema and a perceived lack of control of their body image and inability to predict symptoms and flares.
Jeffrey Cohen, MD, an assistant professor of dermatology at the Yale School of Medicine and one of the study’s co-authors, emphasized the critical importance of early detection and understanding the nexus between eczema and eating disorders when it comes to patient care.
"Early detection of eating disorders is essential, and understanding that those with eczema are at higher risk may help with early diagnosis," Cohen said. "Both eczema and eating disorders have a profound impact on an individual's life, and understanding the connection between the two will enable health care teams to provide more comprehensive care."
Study co-author Marney A. White, PhD, MS, a clinical psychologist and professor of public health (social and behavioral sciences) at the Yale School of Public Health, echoed Cohen's sentiments, emphasizing the interdisciplinary nature of their research.
"This study is a transdisciplinary collaboration of researchers in dermatology, psychiatry, and epidemiology and is one of the first reports of its kind,” White said. “The findings are important for clinicians working with patients with skin diseases, to understand the significant body image disturbances that can occur, and to refer patients to psychological support."
It is not just the findings that set this project apart, but also the collaborative spirit behind it.
Cohen and White discovered their mutual research interests when Cohen enrolled in the Yale School of Public Health’s Executive Master of Public Health program, in which White is a member of the teaching faculty. The chance encounter laid the foundation for the published study and its multidisciplinary investigative approach.
Gloria F. Chen, a medical student at Yale School of Medicine, is the paper’s lead author. Suzanne Xu, a member of the internal medicine residency program at Brigham and Women’s Hospital, also contributed as co-author.
The findings carry significant implications for health care professionals, emphasizing the importance of addressing both dermatological and mental health needs in patient care, the authors said. By recognizing the link between eczema and eating disorders, clinicians can tailor interventions to better support patients and provide holistic support to individuals affected by these conditions.
For additional information, contact Jeffrey M. Cohen, MD, at jeffrey.m.cohen@yale.edu