Could chronic dieting and disordered eating be causing your gut issues?

by | Apr 19, 2021

Disordered eating occurs when individuals regularly engage in eating patterns that involve, skipping meals, limiting foods, or following a restrictive diet (eg, Paleo or ketogenic). Disordered eating is often seen in irritable bowel syndrome (IBS) as a way to avoid or prevent symptoms. Elimination diets commonly used to diagnose or treat food triggers in IBS can also encourage excessive restriction of food intake in order to avoid discomfort and create a large amount of anxiety when consuming unfamiliar or forbidden foods.

IBS is commonly reported among people clinically diagnosed with eating disorders [1]. Studies have found that up to 50% of women diagnosed with an eating disorder met the criteria for IBS, and up to 98% met the criteria for at least one functional gut disorder [2]. Interestingly, studies have shown high FODMAP (a form of elimination diet) foods are more likely to cause symptoms in people with eating disorders than those without [3]. While damage to the gut is more severe in clinically diagnosed eating disorders, engaging in disordered eating behaviours such as chronic dieting can cause digestive symptoms.

Disordered eating behaviours can cause GI symptoms in many different ways:

  • Restriction can cause the muscles in the digestive tract to atrophy, or weaken, which can lead to constipation, bloating due to trapped stomach gasses, and gastroparesis, or delayed stomach emptying.
  • Eating limited food variety can disrupt the microflora of the gut.
  • Excessive fibre consumption, from eating too many vegetables, fruits, whole grains and beans can cause extreme gas and bloating.
  • Self-induced vomiting can weaken the oesophageal sphincter, leading to gastric reflux.
  • Use of laxatives can lead to weakening of the gut muscles.

In addition, low calorie foods or methods of appetite suppression utilised in chronic dieting often contribute to GI symptoms:

  • Eating airy, low calorie foods like popcorn or rice cakes, chewing excessive gum, or drinking carbonated beverages to suppress appetite can cause you to swallow a lot of air, which can contribute to reflux and bloating.
  • Many sugar free foods are made with sugar alcohols, that can cause diarrhea and bloating.
  • Coffee is another drink often used as an appetite suppressant, but the caffeine can have a laxative effect.
  • Using excessive water to “fill up” before eating, often leads to reflux by loosening the sphincter from the stomach

The good news being food induced symptoms associated with IBS are often responsive to dietary intervention. Re-establishing regular eating patterns can alleviate the symptoms of functional gut disorders and may help the body tolerate foods that may trigger symptoms.  Working with a Dietitian and Psychologist experienced with Disordered eating and gut issues is beneficial in treating anxiety which can exacerbate symptoms and establish eating patterns to support nourishing the body adequately to assist in highlighting or alleviating food induced triggers for further investigation.