How are eating disorders and irritable bowel syndrome related?

How are eating disorders and irritable bowel syndrome related?

Content Warning: This story contains sensitive details about eating disorders.


Dian Chong’s eating problems started in middle school. Like many girls this age, the media’s focus on women with certain (read: skinny) body types pressures Diane to look a certain way. But there was more: She describes herself as a “sick child” who has always had a hard time eating and digesting food. “A lot of my early memories are that I vomited because I was sick or had stomach ache, which was very painful, so I didn’t fully enjoy eating once I got older,” she says. It became common for Diane to skip lunch at school, not only because she struggled with food but also because she wanted to save money. Diane grew up with a single mother in a low-income family. “Since eating was such a pain for me physically, I thought it was best to save money and get help with expenses at home,” she says.

In middle and high school, Diane says her emotional and mental state moved into the eating disorder territory. Since her mother was often at work, Diane was responsible for her own meals and, in addition to lunch, would often skip dinner, since there was no one around to tell her otherwise. I started exercising constantly, up to six hours a day. After school, she had a little something to eat if she “couldn’t resist” the pangs of hunger, but she usually worked or went to bed early and slept until the next day. This went on for years.

Diane, now 25, is Korean and says that because of her cultural background and low-income upbringing, she didn’t grow up going to the doctor – the concept of healthcare was not a thing in her family. “Even if I felt pain, going to the doctor wasn’t normal,” she says. “I drank water or slept with it.”

By the time Diane arrived at the University of California, Berkeley, when she was an undergraduate, she was so nervous about the idea of ​​a “fifteenth year student” that she ended up loser 15 million pounds. It wasn’t until Dianne began experiencing bouts of nausea and dizziness, which she was worried that it might affect her schoolwork, that she decided to see a doctor. “I didn’t want to fail studies,” she recalls.

Diane’s initial visits to primary care clinicians on campus were intimidating: “I didn’t understand healthcare in the United States or what it meant to communicate your symptoms.” On the first three visits, it wasn’t clear to Diane when and how she should talk about her problems. “There was a standard blood draw and then they would say, ‘Is there anything else you want to talk about? “And I was getting too bogged down trying to explain why I was there. My mind would go blank.”

However, Diane was determined to get help, so before the fourth visit, she made use of her academic training and made a list of what she wanted to discuss. who – which It was a turning point. “Once I got into my schedule, the doctor answered with a series of follow-up questions, like what my diet looked like and whether I went to a dietitian,” she says. From there, Diane was diagnosed with anorexia nervosa with binge eating symptoms, and she visited a gastroenterologist, who told her she had irritable bowel syndrome (IBS). She also met with a nutritionist to set her on a path toward healthy eating habits as well as a therapist to help her get to the root of her eating disorder. She says CBT played a big role in her recovery: “It was really about changing the mindset behind my IBS symptoms and the relationship with food, that I no longer feel ashamed.”

It’s almost as common for people with eating disorders to have an upset stomach. according to Study 2019 Posted in Nutrients, 98 percent of eating disorder patients meet the criteria for a functional gastrointestinal disorder (FGIDs). The most common is IBS. But one does not necessarily cause the other. Alexandra VossMD, a psychologist who specializes in digestive health at Yale New Haven Hospital, says he “lays a chicken or an egg” depending on the patient’s presentation. “Disordered eating behaviors can lead to significant stress on the body through significant nutritional deficiencies and physical stress caused by compensatory behaviors such as vomiting, overuse of laxatives or excessive exercise which can in turn lead to gastrointestinal motility complications, esophageal erosion, and increased inflammation , and so on.

On the other hand, some people, like Diane, have IBS symptoms like stomach aches or difficulty digesting food first — and change their eating habits accordingly. “When people start associating food with their symptoms, this can lead to a fear of eating, restricting certain food groups, leading to avoiding certain foods completely or overeating,” he says. Lynne O’Connor, MD, director of colorectal surgery in New York. “This kind of relationship with food can cause anxiety about eating and emotional stress, which can lead to changes in the gut, and even alter the composition of bacteria in the gut, which can contribute to IBS.” In other words, disordered eating habits can increase the chances of developing a digestive health problem, and vice versa as well.

John DamianosMD, an internist who focuses on gastroenterology at Yale New Haven Hospital, says that this is, in a way, a completely normal response. “If any of us had a stimulus that was bothering us, we would avoid it,” he says. “But as abnormal eating patterns persist, this can eventually develop into actual eating disorders such as anorexia nervosa, bulimia, and avoidance/restriction eating disorder (ARFID).”

“Disordered eating behaviors can put a lot of stress on the body.”

In anorexia, defined as an abnormal decrease in body weight due to an intense fear of gaining weight and/or a distorted idea of ​​weight, “people often experience constipation, gas, and bloating as a result of decreased bowel activity and delayed emptying from not eating enough.” For long periods of time, he explains Gina Volpi, a registered dietitian based in Round Rock, Texas. “Food is not eaten in large enough quantities to simulate the digestive system and the smooth muscles responsible for digestion and bowel movement, thus slowing down the gut.” For those with bulimia, which can entail purging food in the form of self-regurgitation, laxative abuse, and over-exercising, the food that Do Eating food either does not make its way completely through the entire digestive system (in the case of auto-vomit), or is propelled through the system too quickly (in the case of laxatives) which may disrupt normal digestive biochemistry. Dr. Damianos adds that osteoporosis, or pathological obsession with healthy eating, has been suggested as an emerging disorder, and can also lead to IBS symptoms.

Just ask Erin Decker, 31. While she’s not sure which started first, her disordered eating habits or IBS symptoms, she describes it as a “natural consequence” of being a relatively anxious, high-stress person. She furthered her studies to become a registered dietitian orthopedist, and decided to seek help as soon as it began affecting her relationship with friends and family. Today, as a registered dietitian who works with clients with eating disorders, she says, “It’s very important to think about my self-care. I’m also a new mom, so it’s easy to lose time and forget to eat regular meals or seek help. I notice symptoms that My IBS works more when these needs are not being met.” She adds that the motto “Don’t let perfection stand in the way of the best” helps, too.

Emily R. says: , 28, said her troubled eating habits started first, as she had intermittent anorexia for 12 years. Along the way, she began experiencing constant periods of constipation. “I started to realize how much time and space it takes to think about food and bowel movements – so much that I couldn’t be a friend or partner – and I knew I needed to seek help,” she recalls. Emily was told she had IBS-C, a A type of Irritable Bowel Syndrome Where constipation is the main symptom. Now she is actively meeting both a therapist and a dietitian who specializes in eating disorders, in addition to reducing stress, taking magnesium supplements and drinking peppermint tea, without joking, telling her stomach nice things. “It sounds massive, but don’t knock it until you’ve tried it,” she adds.

Diane says that by combining her own treatment with working with a dietitian, she now considers herself a foodie. “I think about the time I lost enjoying different foods from different cultures, and now I am always looking for recommendations. Trying new things with my partner and friends has become an adventure. I would have never believed this in elementary school, but now, food is an art form that I enjoy To right.”

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