 Some authors suggest that medical professionals should evaluate the presence of an unrecognized celiac disease in all people with eating disorder, especially if they present any gastrointestinal symptom (such as decreased appetite, abdominal pain, bloating, distension, vomiting, diarrhea or constipation), weight loss, or growth failure; and also routinely ask celiac patients about weight or body shape concerns, dieting or vomiting for weight control, to evaluate the possible presence of eating disorders, specially in women.Child abuse which encompasses physical, psychological and sexual abuse, as well as neglect has been shown to approximately triple the risk of an eating disorder.Sexual abuse appears to about double the risk of bulimia; however, the association is less clear for anorexia.