Digestive issues like bloating, constipation and diarrhea are among everyone. But individuals with disordered eating patterns and eating disorders are even more likely to struggle with GI distress like Irritable Bowel Syndrome (IBS).
The Prevalence of GI Issues Among People with Eating Disorders
Research suggests there’s a bidirectional relationship between eating disorders and irritable bowel syndrome, or IBS. A 2021 systematic review found that patients with gastrointestinal disorders had up to 55% higher prevalence of disordered eating compared to healthy individuals. Higher rates of disordered eating were observed in patients with disorders of gut-brain interaction (irritable bowel syndrome, reflux hypersensitivity, or functional dyspepsia) compared to organic gastrointestinal disorders (Crohn’s disease, ulcerative colitis).
Why is There So Much Overlap Between Eating Disorders and IBS?
There are likely many factors that contribute to the overlap between these two patient populations. Consider the fact that one of the first line treatments for conditions like IBS are elimination diets. These meal plans, which aim to identify dietary triggers causing uncomfortable digestive symptoms, temporarily eliminate entire food groups from the diet. Though sometimes helpful in alleviating GI distress, these severe dietary restrictions can lead to disordered eating patterns in people susceptible to developing EDs. More on that in a minute.
On the other hand, engaging in disordered eating behaviors and restricting entire food groups can significantly disrupt digestion, thus upping one’s risk of developing IBS. For example, significantly under-eating can slow down motility of the GI tract and result in constipation.
You can think of the link between eating disorders and IBS as a chicken-or-the-egg situation. The good news? Re-nourishing the body by eating adequately and consistently can be hugely helpful in resolving IBS-related GI symptoms.
How Exactly Does Disordered Eating Affect Digestion?
Disordered eating behaviors can disrupt digestion in a variety of ways. Here are a few examples:
- Irregular eating patterns such as engaging in the binge/restrict cycle can lead to constipation, diarrhea, bloating, abdominal distention, delayed gastric emptying, gastroparesis, and early satiety.
- Compensatory behaviors such as purging or laxative abuse can cause serious complications such as acid reflux, GERD, or weakening of the abdominal muscles.
- Eating diet foods with high amounts of added fiber and non-nutritive sweeteners can promote diarrhea.
- Eating large amounts of high-volume, high-fiber foods such as raw fruits and vegetables can lead to bloating, constipation, gas, diarrhea and/or abdominal discomfort.
- New research also suggests that restrictive eating patterns may negatively impact the gut microbiome and intestinal function by altering communication pathways along the gut-brain axis. Further research on this topic is needed.
What Should I Prioritize: IBS Treatment or ED Recovery?
Elimination diets like the low FODMAP diet are one of the most common interventions for IBS. Many of these restrictive meal plans require the complete avoidance of foods that are commonly thought to be inflammatory. Examples are gluten or dairy. While these dietary changes may provide relief from IBS symptoms, it’s safer for individuals struggling with EDs to prioritize renourishing the body with adequate energy and sticking with consistent eating patterns throughout the day. Here’s why: With adequate nourishment comes a wider variety of foods in the diet. That encourages a more diverse gut microbiome. Eating more regularly throughout the day also supports more regular bowel movements. Oftentimes these changes alone can resolve ED-linked gut issues without the need for elimination diets.
What If My IBS Persists Past Recovery?
Real talk: This is not uncommon. Adequate nourishment and resolving disordered eating behaviors often reduces adverse GI symptoms. However, it’s not uncommon for digestive struggles to persist in the ED recovery phase. This is because functional gastrointestinal disorders like IBS can be triggered by a number of different things. These include lack of sleep, changes in daily routines, stress, and anxiety. If this is the case for you, know that there are non-diet interventions that have been shown to be just as effective for repairing gut health as traditional dietary modifications. Practices such as yoga, meditation, gut-directed hypnotherapy, and mindfulness can be very effective in reducing GI symptoms.
The Takeaway
It’s common for GI issues to lead to disordered eating behaviors and for disordered eating behaviors to lead to GI issues. Either way, a limited diet and undernourished body will negatively impact your recovery from both. We recommend working with a team of credentialed professionals (think: a registered dietitian, gastroenterologist, PCP, and therapist) who can identify the best treatment path for you. Reach out to a Culina Health dietitian today to start your road to recovery.
