Matilda Black

University of Cambridge, United Kingdom

Title: The Comorbidity between Eating Disorders and Functional Gastrointestinal Disorders

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Biography

Matilda Black a fourth-year medical student at the University of Cambridge, where I also completed an intercalated BA in Natural Sciences. In addition, she undertook a year-long research programme at Columbia University Irving Medical Center. During her intercalation she worked with Dr Margaret Westwater, a cognitive neuroscientist. Our research combined cognitive neuroscience and pathophysiology to explore shared mechanisms between eating disorders and gastrointestinal disorders. These experiences have shaped my interest in the intersection of physical and mental health and strengthened my commitment to an interdisciplinary approach to medicine that integrates biological, psychological, and social dimensions of patient care.

Abstract

The Comorbidity between Eating Disorders and Functional Gastrointestinal Disorders

This review assessed evidence explaining the comorbidity of eating disorders (EDs) and functional gastrointestinal disorders (FGIDs), to improve understanding of shared mechanisms and implications for clinical management. It evaluates whether ED-associated behaviours increase FGID risk, whether FGIDs may precede EDs, and the temporal sequence of onset. We hypothesised that overlapping mechanisms contribute to their co-occurrence. 

We conducted a comprehensive literature review, where relevant studies were identified using targeted keyword searches (e.g., "disorders of the gut-brain axis") in academic databases. Inclusion criteria prioritized relevance, recency, and contribution to understanding shared mechanisms.

A strong relationship was identified between EDs and FGIDs, with many FGID patients having prior ED diagnoses. Both conditions exhibited shared psychopathology, overlapping personality traits, and perturbations in gut-brain signaling. We identified distinct alterations in genetic factors, inflammatory processes, and psychiatric traits. Our findings were suggestive of several bidirectionally causal mechanisms between EDs and FGIDs, suggesting causal associations exist, rather than just correlation.

Bridging the gap between mental and physical health by integrating brain-body care may enhance clinical outcomes. EDs and FGIDs are serious health conditions that have high rates of comorbidity. Dual diagnoses are associated with poorer clinical outcomes, yet the mechanisms underlying the co-occurrence of these disorders remain poorly understood. Shared genetic, physiological, and neurocognitive factors may play significant roles in their pathogenesis, but systematic evaluation is lacking. Addressing this gap will advance knowledge of shared etiological mechanisms, which could, in turn, inform more effective clinical interventions and improve prognoses.