For those of us living with digestive conditions like irritable bowel syndrome (IBS), the stomach pains, bloating, diarrhea, constipation, and other IBS symptoms and gastrointestinal challenges can be scary and overwhelming. It's no surprise that, over time, we learn eating behaviors in an attempt to calm our angry bellies. Unfortunately, these behaviors can often lead to eating disorders like anorexia or bulimia or disordered eating like Avoidant Restrictive Food Intake Disorder (ARFID). If you're struggling with this, first and foremost, know that you're not alone. We still have a lot to learn, but early systematic reviews show 25% of IBS patients have disordered eating patterns. And 90% of patients with anorexia or bulimia have functional GI symptoms.*
Also, you should know that there is a lot of information, resources, and support out there to support your healing. Working with a Registered Dietitian with a specialty digestive health and eating disorders can be transformative in making process. You can use the “Expertise Area” on the Academy of Nutrition and Dietetics directory to find a dietitian specialist. Also, the National Eating Disorders Association site has a wealth of wonderful resources.
To support you on your journey, we asked Registered Dietitian Nutritionist expert Lauren Adler Dear, MS, RDN for her top 3 tips:
1. Eating disorder behaviors exacerbate digestive issues, and you need a proper diagnosis and treatment.
Restriction, binging, purging, and laxative abuse can all potentially cause negative effects on the digestive system. Though people may tell you that not engaging in those behaviors will make your GI symptoms get better, that is often not the case. GI symptoms can persist even after recovery. You deserve diagnosis and proper treatment from a GI healthcare professional.
2. If you are on a restrictive diet, cutting out more foods is not likely to help your symptoms in the long run.
You may have tried a special diet such as the low FODMAP diet for IBS and found that it helped some, but you still continue to have symptoms. Cutting more foods out is not always the answer! It ultimately makes it harder to bring foods back in, leaving you with a nutritionally inadequate diet. Please seek help from a Gastroenterologist and Registered Dietitian if you have ongoing digestive symptoms.
You may find that any new food causes digestive distress at first. This may be because the body is not used to it, but it could also be due to the anxiety or anticipatory fear that the food will cause you symptoms. Do not let this stop you from continuing to test new foods. Go slow and try one food at a time if you are concerned about symptoms.
3. Eating regularly and eating an adequate amount of food is imperative for both healing the gut and treating an eating disorder.
Many people with IBS avoid eating due to the digestive pain or discomfort it causes. While this may help in the short term, it will make your symptoms much worse in the long run. The GI tract needs adequate and regular meals (every 3 to 4 hours) to function properly. And this is exactly what you need to help recover from an eating disorder as well.
Sources:*Gastroenterology & Hepatology, May 2019 - Volume 15, Issue 5: Irritable Bowel Syndrome, Disordered Eating, and Eating Disorders, Kimberly N. Harer, MD, ScM