There has been a growing awareness of the relationship between eating disorders and IBS in recent years. While the two conditions may seem unrelated at first glance, a closer look reveals a connection that impacts both physical and mental health.
In this blog post, we’ll explore the complex interplay between eating disorders and IBS, exploring how they can influence each other and providing tips for how to manage these two challenging conditions.
Understanding Eating Disorders
Eating disorders are serious mental health conditions that affect millions of people worldwide. In Canada alone, almost one million people are living with a diagnosable eating disorder. Plus, millions more are struggling with their relationship with food and a preoccupation with weight.
Eating disorders don’t discriminate. They can affect people of all ages, genders, classes, races, ethnicities, and abilities. Eating disorders are not a choice. Many factors can contribute to their development, including genetics, mental health, and cultural factors related to food and what kind of body types are deemed desirable.
Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder. These eating disorders are characterized by unhealthy relationships with food, body image, and eating habits. You can’t always tell if someone has an eating disorder. Many people who have eating disorders look healthy but may in fact be very ill.
The Impact of Eating Disorders on the Gut
Studies have shown that people with eating disorders often experience gastrointestinal (GI) symptoms like bloating, constipation, and diarrhea. In fact, up to 90 percent of people with anorexia or bulimia have functional GI symptoms. These symptoms can mirror those of IBS, making it challenging to diagnose and manage both conditions at the same time.
Eating Disorders and Stomach Emptying
Studies of people with anorexia have shown that the emptying of the stomach slows down when food is chronically restricted. This is a condition called gastroparesis. This can lead to feeling full more quickly after eating, which can make it more difficult to eat enough. This then feeds into the disordered eating, as a person may further restrict food if it’s uncomfortable to eat.
Eating Disorders and the Gut Barrier
The gut has an important barrier that keeps dangerous substances and bacteria from entering the gut. Normally, it is just “leaky” enough to allow nutrients to enter. However, studies have found that extreme food restriction can make the gut leakier.
It’s thought that for people with anorexia, stress and the lack of nutrients causes the gut to become leakier, which can be detrimental to overall gut health. However, this has only been shown in animal studies, and more research needs to be done in humans.
Eating Disorders and the Gut Microbiota
Finally, research shows the chronic food restriction can have an impact on the gut microbiota. One study found that people with anorexia nervosa had increased numbers of mucous-degrading bacteria in their gut. Since these bacteria feed off the mucous layer of the gut barrier, this can lead to a leakier gut and poorer gut health.
Eating Disorders and IBS: The Connection
IBS is a chronic disorder of gut-brain interaction characterized by abdominal pain, bloating, and altered bowel habits like diarrhea and constipation. Emerging research highlights a significant overlap between eating disorders and IBS.
It appears that altered eating patterns and the stress associated with eating disorders can trigger IBS symptoms or make them worse. Conversely, the physical discomfort of IBS can contribute to the development of disordered eating habits as people avoid certain foods to try to find relief from their digestive issues.
An eating disorder commonly associated with IBS is avoidant/restrictive food intake disorder (ARFID). This eating disorder involves food restriction resulting from a fear of negative consequences associated with eating certain foods. A study found that almost 20 percent of adults at an outpatient GI clinic screened positive for ARFID. Plus, IBS patients were twice as likely as patients without IBS to screen positive for ARFID.
Managing concurrent eating disorders and IBS requires a multidisciplinary approach. Here are some strategies to consider:
Seek Professional Help
Consult with healthcare providers, including mental health professionals, dietitians, and gastroenterologists, to create a treatment plan that is unique and tailored to you.
Address Mental Health
When treating eating disorders and IBS, treating the underlying eating disorder is crucial. Therapy and support groups can provide much-needed tools to improve body image and your relationship with food.
Stress can worsen IBS symptoms, as well as trigger eating disorder behaviours. Mindfulness, relaxation techniques, and stress-reduction strategies can be helpful.
One type of relaxation technique that is effective for managing IBS is gut-directed hypnotherapy. This is a treatment that addresses the miscommunication between the brain and the gut that is common in people with IBS. In the case of one of Keren’s clients, gut-directed hypnotherapy helped them feel calmer and less anxious. This resulted in a significant improvement in their digestive symptoms.
Get Nutrition Guidance
A registered dietitian can help people with both eating disorders and IBS develop a balanced and sustainable eating plan to support gut health while fostering a healthy relationship with food.
While many people focus on restricting certain foods when they have IBS, if you’re also trying to manage an eating disorder, food restriction is likely not appropriate. In this case, working with a dietitian to develop an eating plan that nourishes you while relieving IBS symptoms is crucial.
Consider Medication if Other Strategies Are Not Successful
In some cases, medication may be needed to manage IBS symptoms or underlying mental health conditions. Needing medication does not mean you’ve “failed” to manage your condition – it just means you need another tool from the IBS and eating disorder care toolbox.
The link between eating disorders and IBS is complex and multifaceted, but understanding the connection is crucial for seeking effective treatment and management. If you or someone you know is struggling with these conditions, it’s important to seek professional help.
Keren is a registered dietitian with experience working with people who are struggling with GI symptoms. Click here to book a free 15-minute discovery call to see if you would be a good fit for working together.