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Psychophysical chemosensory dysfunction in eating disorders: a qualitative systematic review

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Abstract

Purpose

Patients with chemosensory dysfunction experience significant quality of life disruptions, including reduced enjoyment of eating. While chemosensory dysfunction has been associated with eating disorders, the relationship is poorly understood. This systematic review aims to characterize psychophysical gustation and olfaction in patients with eating disorders.

Methods

Systematic review of investigations assessing psychophysical chemosensory function in patients with organic eating disorders.

Results

26 studies were included. Five studies assessed both chemosenses, while 12 and 9 assessed exclusively gustation or olfaction, respectively. In total, 779 patients were included [72.4% anorexia nervosa (AN), 26.7% bulimia nervosa (BN), 0.8% combined AN/BN]. Patients with eating disorders experienced rates of hypogeusia up to 87% in AN and 84.6% in BN. There was evidence for alterations in psychophysical olfaction, but orientation of trends were less clear. Chemosensory dysfunction was more evident in AN patients. Treatment correlated with improved chemosensory function.

Conclusions

Despite heterogeneity in study methodology and results, this review demonstrates that patients with eating disorders experience some degree of chemosensory dysfunction, particularly in gustation. This symptomatology overlaps with those experienced by patients with other causes of chemosensory impairment. These findings suggest potential broad psychosocial, dietary, and mental health implications in patient populations experiencing chemosensory dysfunction.

Level of evidence

Level II.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline St, 6th floor, Ste 6230, Baltimore, MD, 21287, USA

    Evelyn M. Leland, Deborah X. Xie, Sandra Y. Lin & Nicholas R. Rowan

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Vidyulata Kamath

  3. Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Stella M. Seal

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  1. Evelyn M. Leland
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  2. Deborah X. Xie
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  3. Vidyulata Kamath
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  5. Sandra Y. Lin
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Contributions

Literature search was performed by SS. EL and DX performed literature review, data extraction, and data analysis. The first draft of the manuscript was written by EL. NR, SL, and VK critically revised the work. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Nicholas R. Rowan.

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Leland, E.M., Xie, D.X., Kamath, V. et al. Psychophysical chemosensory dysfunction in eating disorders: a qualitative systematic review. Eat Weight Disord 27, 429–447 (2022). https://doi.org/10.1007/s40519-021-01189-2

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