Did you know that 50% of women with eating disorders meet the criteria for IBS? Or that 98% meet the criteria for at least one gut disorder?
Even with all the research out there, and even though most evidence shows that eating disorders are the cause of such gut disorder diagnoses, it’s still not known which comes first, the eating disorder or the gut disorder.
Additionally, everyone’s situation and relationship with food are different. Not all eating disorders look exactly the same, and neither do gut disorders. But it is known that gut health and eating disorders are closely linked.
But what issue came first? How are they related? Let’s take a look at the close relationship between eating disorders and gut health.
Impaired gut motility
Caloric restriction happens when you reduce the average amount of calories consumed per day below the standard amount. When this happens, it can cause the vital organs to starve and your digestive organs to atrophy. Your gut is a muscle – if you don’t use it, you lose it.
In less severe cases, however, it causes constipation, bloating, gas, and gastroparesis. People who have eating disorders tend to have a higher risk of bloating, nausea, acid reflux, and prolonged fullness after a meal.
Because individuals with eating disorders are very aware of all body sensations, sometimes bloating is wrongly perceived as “feeling fat” or gaining weight, which can greatly impact recovery.
Gut Dysbiosis
Dysbiosis is the imbalance of the various organisms in your microflora. That’s why when you limit the variety of food you eat due to an eating disorder, your gut’s microflora balance and digestive enzyme production are disrupted. This can lead to a worsening of already established food intolerances or cause new ones to form.
Essentially, if you remove a particular food group and don’t consume it for a long time, it’ll shock your body when you do eat it and cause you to feel sick. For example, if you read somewhere that a specific food group is bad for you and you remove it from your diet, your body will stop producing the enzymes needed to digest that food and the strains of bacteria that help won’t proliferate.
The moment you decide to eat that food, your body won’t be able to digest it properly, and it will make you feel unwell or sick with bloating, indigestion, gas, diarrhea, or chronic constipation. Consequently, this will also reinforce that this food is “bad” for you, creating a chaotic cycle.
However, it is reversible once you start eating a non-restrictive diet again.
Too much fiber
When people are trying to lose weight or eat healthier, basic dieting and weight loss efforts are often turned to, like reducing refined carbs and fats and increasing overall intake of whole foods.
If a person eats excessive amounts of fiber like vegetables or bran, but mostly in a supplement form, these can cause excess gas and bloating, especially when dysbiosis and bacteria overgrowth is already occurring.
Swallowing too much air
Individuals with eating disorders often use high-volume food to suppress appetites and reduce calorie intake. But consuming things like carbonated drinks, gum, popcorn, or rice cakes can actually cause you to ingest a lot of air!
Though air has no nutritional profile, it can make you feel and look bloated because it adds volume to your gut.
Laxative abuse
Often, laxatives are a staple in the lives of people with eating disorders, either as a weight-loss tactic (over-the-counter laxatives, magnesium,…) or to suppress appetite (natural laxatives like coffee.)
But another use is also to get the gut moving due to impaired bowel function due to being undernourished. Laxative abuse impairs your digestive system’s normal muscle tone and can cause a “lazy gut,” meaning when you abuse laxatives, your gut essentially becomes incapable of contracting and digesting properly.
Additional additives
Because sugar is seen as one of the ultimate villains of any diet, many people cut it out and replace it with a ton of sugar-free options that are loaded with other types of sweeteners in place of sugar. Some of the sweeteners even show a connection between the sweeteners and IBD and dysbiosis if consumed too often over a long time period.
Although it’s likely not harmful in moderation, consuming too many excess sweeteners can cause digestive distress. But because people with eating disorders often replace foods with low-sugar, low-calorie foods, it’s quite possible to overdo it and irritate the gut.
Mental health
Research shows that those with eating disorders who have higher amounts of stress and anxiety also tend to have functional gut disorders like IBS, bloating, and constipation. It’s possible that a mental health disorder is the root cause of both the anxiety and the eating disorder, and it’s also possible that both of them are making each other worse as well.
For example, people who have high levels of anxiety, when anxious, experience physical symptoms like bloating, gas, or an upset stomach. And these symptoms can make anxiety worse.
Gut health tips
I know it can be hard to transition from disordered eating patterns into healthy eating patterns and a healthier relationship with food. Here are some tips to help you heal in a healthy way:
- Have daily breakfast– Natural gut contractions usually happen early in the morning. Take advantage of that “natural time” and get your body’s functions moving.
- Stay hydrated– Make sure you drink enough water throughout the day and during your meals.
- Eat consistently– In order to start picking up on your hunger cues and to regulate motility patterns, start by eating at least 3 meals and 2-3 snacks a day consistently. Eating regularly can get your gut used to contracting at a more regular time. This is the only way that you can begin to eat intuitively if you have an active eating disorder.
- Variety– When you have an active eating disorder, this step can be easier said than done. I know how scary it can feel, but working towards incorporating a variety of foods into your diet is necessary to reduce food fears and improve gut bacteria.
- Manage stress– Stress has a huge impact on our gut, so managing your stress is important. If possible, incorporate stress-relieving strategies into your daily routine, like yoga, breathing exercises, and meditation.
- Include movement in your day– you don’t have to work out intensely, but getting your blood flowing and your abdomen moving for about 30 minutes per day with some sort of movement is important.
- Social media detox– Unfollow any social media accounts that say that a diet will heal your gut or that make you feel unhealthy
The bottom line is that unless you’ve consulted with a dietitian, you shouldn’t be following any specific restrictive diet (like the FODMAP diet)— especially if it’s either because of something you saw on social media or was suggested to you by someone who isn’t a dietitian (indeed, even your physician doesn’t have the best answer). In fact, the more you restrict, the more it can worsen your relationship with food and even trigger your eating disorder, getting you back into that vicious cycle.
That’s why working with a dietitian is the best way to ensure you begin to heal your gut in the right way because they’ll be able to walk you through every step of your journey. And by working with a dietitian, you’ll get the right tools and will always have a support system.
But I know it can be hard and uncomfortable to work different foods into your diet and create new healthy habits when you’re trying to recover from an eating disorder. It’s a slow process, but it’s a worthwhile one.
I do hope these tips help you and bring you comfort, especially when you’re having a rough day.