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The Relationship Between Disordered Eating and Digestive Issues

Written by Megan Lee, Registered Dietician. May 2024



What came first - disordered eating or digestive issues? It is very common for those who suffer with digestive issues to develop disordered patterns of eating in their attempt to manage symptoms and discomfort. It’s completely understandable that people would want to scrutinise and control their diets in order to get some relief. However, these efforts are often futile - further exacerbating digestive discomfort. Similarly, existing disordered eating behaviours or eating disorders can cause digestive disorders, which then further intensify the need to engage in disordered patterns of eating to manage gut symptoms.


How does disordered eating cause digestive issues?


  1. Malnutrition

When the body is underfed, the muscles in the gastrointestinal tract weaken. This results in a slower movement of food-stuff through the digestive tract. It’s kind of like a toothpaste tube - the weaker your squeeze, the slower the toothpaste comes out. This can cause constipation, bloating from trapped gas and delayed stomach emptying which creates an extended period of ‘fullness’.


2. Slowed Metabolism

When the body gets less energy than it needs, metabolism slows in order to conserve energy for vital functions like breathing and keeping the heart beating. This means that less energy is available for digestive processes, again resulting in constipation, bloating, slowed stomach emptying and abdominal pain.


3. Limited Food Variety

Our gut microbiota need a variety of foods and types of fibre in order to thrive. When many foods or total food groups are eliminated, the microbiota have less fuel to multiply and protect our digestive tracts.


4. Binge/disinhibited eating

Individuals who consciously restrict their food intake to control their weight (restrained eaters) are more susceptible to episodes of overeating or "disinhibited eating" when their self-control breaks down. The sudden intake of high volumes of food, especially those high in fats and sugars, can strain the digestive organs. Overeating can also cause the stomach to produce excess acid, which may lead to acid reflux or heartburn. In addition, rapid consumption of food can impair proper chewing and digestion, making it harder for the body to break down and absorb nutrients effectively.


5. Anxiety

Those with eating disorders for disordered eating often experience anxiety around meal times. This anxiety activates the sympathetic nervous system - the fight or flight state - which causes blood to flow to the extremities instead of the gut. The result? Insufficient digestion of and transport of food.


6. Purging Behaviours

Regular use of laxatives weakens the muscles of the colon. Overtime, the bowel becomes lazy and relies on laxatives to move food-stuff along. This often results in constipation and bloating, which is then only relieved by the use of more laxatives. A vicious cycle ensues.


Self-induced vomiting can result in the weakening of the muscle that keeps food from traveling from the stomach up into the oesophagus. When there is an increased pressure in the stomach - like after eating a meal - one can then experience reflux as the food is pushed through the valve that typically keeps food in the stomach.


7. Overuse of Diet Foods

It’s typical of those with eating disorders or disordered eating to opt for artificially sweetened foods. Some of the non-nutritive sweeteners in diet foods may negatively impact gut microbiota, resulting in dysbiosis - an imbalance between beneficial and harmful bacteria in the gut. Dysbiosis can cause symptoms such as diarrhoea, constipation, bloating, excessive wind, nausea and abdominal pain.


How do digestive issues lead to disordered eating?


  1. Restriction / Elimination

Those who struggle with digestive issues or digestive disorders often eliminate or restrict certain foods or food groups in an attempt to manage their symptoms and discomfort. In many cases, this can develop into anxiety around eating different foods and avoidance of many foods.


2. Chaotic Meal Patterns

Many people with gut issues will skip meals to avoid the subsequent physical discomfort. A fear of eating may develop as the association with eating and discomfort or pain is strengthened.


3. Anxiety / Depression

About 90 percent of our serotonin (the ‘happy’ chemical) is produced in the gut. An alteration of the gut microbiome can affect the amount of serotonin produced by the gut. Those with gut microbiota imbalance are therefore at a higher risk for anxiety and depression - two role players in the development of eating disorders.


As you can see, there is a deep-rooted connection between disordered eating and gut issues, and one often feeds into the other. If you are struggling with gut issues, eating behaviours, or both, we are here to help you navigate your relationship with food and symptoms management.



References

Barandouzi, Z.A., Lee, J., del Carmen Rosas, M. et al. Associations of neurotransmitters and the gut microbiome with emotional distress in mixed type of irritable bowel syndrome. Sci Rep 12, 1648 (2022). https://doi.org/10.1038/s41598-022-05756-0


Herpertz-Dahlmann, B., Seitz, J. & Baines, J. Food matters: how the microbiome and gut–brain interaction might impact the development and course of anorexia nervosa. Eur Child Adolesc Psychiatry 26, 1031–1041 (2017). https://doi.org/10.1007/s00787-017-0945-7


Richardson, IL & Frese, SA. (2022) Nonnutritive sweeteners and their impacts on the gut microbiome and host physiology. Front. Nutr.9:988144. doi.org/10.3389/fnut.2022.988144


Harer K. N. (2019). Irritable Bowel Syndrome, Disordered Eating, and Eating Disorders. Gastroenterology & hepatology, 15(5), 280–282.




For personalised guidance on making nutritious and satisfying food choices that suit your individual needs, book a consultation here: https://www.gabimeltzerdietician.com/book-online.

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