"Editor’s Note: This essay discusses eating disorders. Please take care of yourself if those topics could be triggering.
I’ve dealt with chronic constipation, abdominal pain, painful gas, bloating, and acid reflux for what feels like forever (you name it, I’ve felt it). My digestive woes have kept me from enjoying vacations to the fullest and had me doubled over in the bathroom more times than I can count, praying something wasn’t seriously wrong with me. I went to the doctor again and again, hoping to get answers and desperate for anything that would give me relief. But they never found anything wrong.
It wasn’t until I started recovery from my 10-year battle with an eating disorder (a mix of anorexia and bulimia that my therapist diagnosed as OSFED, or “Other Specified Feeding or Eating Disorder”) that I finally felt relief from my stomach issues. After some good old internet research and with the help of an anti-diet dietitian, I learned how deep the connection is between disordered eating and an unhappy gut; up to 98 percent of people with an eating disorder have functional gastrointestinal disorders like IBS.
Trying elimination diets like going gluten-free and the low-FODMAP didn’t work for me; the solution I needed was healing my relationship with food overall. When I learned to accept all foods (even the indulgences that bring me joy) as nourishment for my body, my gut got better. But don’t just take my word for it—I asked experts to explain the connection between disordered eating and gastrointestinal (GI) issues and how healing your relationship with food can benefit your gut.
Rachael Hartley, RD, LD
Rachael Hartley, RD, LD, is a nutrition therapist and certified intuitive eating counselor. Hartley opened her private practice in 2014, where she specializes in intuitive eating, disordered eating and eating disorders, and digestive disorders. She is the author of Gentle Nutrition: A Non-Diet Approach to Healthy Eating.
Lydia Carron, MS, RD, CDN
Lydia is a registered dietitian nutritionist specializing in gastrointestinal conditions. Carron provides treatment for IBS, Celiac Disease, GERD, and other functional and other GI disorders. She also supports clients with eating disorders in effectively managing their GI symptoms while on their recovery journey.
The Connection Between Disordered Eating and Gut Health
Stress affects the gut through the gut-brain axis
If you’ve ever felt an upset stomach before a date or interview, you know that stress affects your gut. One way disordered eating and gut health are connected is through the gut-brain axis, which links digestion to the brain. “The link between the brain and gut is one of the strongest connections in the body,” explained Lydia Carron, MS, RD, a registered dietician nutritionist who specializes in gastrointestinal conditions. “The gut often responds to environmental stressors before your brain does. When someone is in constant fight or flight and cortisol is elevated (which is often the case for someone with an eating disorder), digestion slows, motility of the GI tract is impacted, inflammation of the gut can increase (i.e., IBD), and a number of other GI symptoms can occur (bloating, gas, pain, diarrhea, constipation, nausea, etc.).”
When the body thinks you’re getting chased by a tiger, all its energy needs to go to fighting or running away (the fight or flight response), so digestion is halted until the body knows it is “safe” and no longer needs to run away or fight. Today, stress is more often caused by a work deadline, or even stress about eating itself (such as the nutritional facts of a cookie), but the body still perceives that as a threat and therefore halts digestion to be able to run away faster.
Not eating enough can harm gut health
We know that the best way to promote a healthy gut is by consuming a variety of whole foods, including protein, fats, and carbohydrates, which ensures you obtain a wide range of nutrients necessary for optimal gut function. Many symptoms of disordered eating, such as restricting calories, limiting eating windows, or cutting entire food groups like carbohydrates and fat can result in lacking nutrients needed to help the gut thrive. “It may seem obvious, but the food we eat has a major impact on gut health,” said Rachael Hartley, RD, LD, certified intuitive eating counselor and author of Gentle Nutrition. “Your gut works best when you’re fueling your body adequately, eating regularly, and eating a wide variety of food to nourish a healthy gut microflora.”
Lydia Carron, MS, RD, CDN, a dietitian who specializes in gastrointestinal issues and disordered eating, sees many clients who have GI issues like bloating, constipation, gas, and acid reflux—symptoms of their restrictive or disordered eating. “If someone is eating below their biological needs for a long time, the rate at which the stomach empties can slow down (also known as gastroparesis). This slowing of digestion can lead to early satiety, acid reflux, feelings of fullness, constipation, gas, etc.”
Digestive issues can lead to disordered eating
Just like disordered eating can lead to digestive symptoms, digestive symptoms can lead to disordered eating. According to both Hartley and Carron, people with IBS or other digestive disorders are predisposed to eating disorders or disordered eating. In fact, Hartley cited that the rate of eating disorders is higher in those with digestive disorders compared to the general population (and a 2022 study supports that).
But, why? Both GI disorders and eating disorders involve the gut-brain axis, and people with GI conditions often make well-intentioned changes to their diet to reduce their risk of GI-related symptoms, which can lead to restricting food or entire food groups. Hartley agreed, specifically when it comes to IBS: “[The digestive disorder] can heighten stress and awareness around food and eating, and there is just an incredible amount of harmful, restrictive, and inaccurate nutrition advice for people with IBS.” Digestive symptoms can lead to fear around food groups or food in general, causing an unhealthy and restrictive relationship with food.
“It felt amazing to be able to listen to the body I was fighting for so long.”
How to Support the Gut While Healing Your Relationship With Food
Work with an anti-diet registered dietitian
If you have a history of disordered eating, talking to a dietician can feel pointless or intimidating. I felt like I didn’t need another person telling me what to eat or judging me for my habits. But, working with an anti-diet dietitian can help you learn how to fuel your body again and manage any symptoms that may come up along the way. An anti-diet dietitian operates from the understanding that diet culture is harmful and flawed, and they won’t use your weight to make assumptions about your health. They understand that food holds emotional, social, and cultural significance in addition to nourishing the body. The anti-diet framework removes judgment about food choices and weight from the conversation. The goal is to not let food be the focal point of your life, in addition to healing the gut.
Because you’ll be encouraged to share details about what types of digestive discomfort you deal with, they’ll be able to provide you with individualized advice. Hartley said they can also advise you on supplements or over-the-counter medications that can help manage symptoms that arise as you’re doing the healing work. For example, my dietitian recommended digestive enzymes to support my digestion as I worked through my disordered eating. Her individualized support helped me learn how to put together grocery lists to make balanced and enjoyable meals while also factoring in my values like veganism (yes, there are vegan anti-diet RDs, too). Working with her made it easier to re-learn my likes, dislikes, and hunger and fullness cues while thinking less about food overall.
Eat regularly and consistently
“One of the best things you can do is eat consistently throughout the day, aiming for regular meals and snacks,” Hartley said. “Simply eating enough food as you heal your relationship with food can help manage symptoms.” If you have had or have a troubled relationship with food, this is easier said than done, but one of the simplest habits that I adopted in my healing journey was eating breakfast to be able to go to the bathroom daily. As my body and gut have healed, breakfast has become a non-negotiable for me.
Make meals and snacks non-negotiables by planning what you’ll eat, setting a specific time to eat it, and following through. Creating a plan can help you prioritize your daily nourishment, putting you on the path to a better relationship with food. Plus, it’ll help your body relearn what it’s like to be fed regularly, which will stimulate proper digestion and nutrient absorption.
Practice mindful eating
Every person is born with the natural ability to regulate their hunger, but disordered eating can often skew or bury those signals. Tapping back into and listening to your natural hunger and fullness cues will take time, which is why it’s so important to work with a dietitian who can help you navigate the journey. In this case, practicing mindful eating means paying attention to how your body is responding to your meals and snacks (Did those tacos fulfill my needs? Do I want anything else right now?) or noticing if you get a little hangry around 3 p.m. and adjusting your meal times accordingly. Eventually, you’ll be able to follow your instincts and intuition when it comes to eating, but for now, give yourself permission to eat unapologetically. After consistently feeding my body and paying close attention to any reaction my body had, I felt the hunger and fullness cues come back—and it felt amazing to be able to listen to the body I was fighting for so long.
Incorporate relaxing techniques around eating
Since stress can negatively impact your digestion, both Hartley and Carron work with their clients on relaxation techniques to alleviate stress around eating and in general. “Having an unbalanced or disordered relationship with food is a stress on the body,” Carron said. The habits that define disordered eating and eating disorders, like restricting, bingeing, purging, ruminating, and chewing/spitting, affect your digestive system, but so does the constant worry about food. Tackling both the habits and the thought patterns is essential. Carron suggested seeking therapy, practicing meditation and diaphragmatic breathing to activate the “rest and digest” system, and prioritizing sleep to lower food-related stress.
Repeating phrases like “I’m allowed to eat” helped me reframe my thoughts about food and lowered the stress when it came time to eat meals, snacks, and desserts. I realized that my body will be able to process the food better if I’m in a positive mindset while eating it.
“Trusting my body was one of the first steps in finally listening to my body and embracing its needs again.”
Don’t lose hope if digestive issues get worse at first
I’m not going to sugarcoat it: This may be one of those it’s-going-to-get-worse-before-it-gets-better situations. For some, GI symptoms (namely fullness, bloating, and gas) can increase when you start eating more regularly, adding more calories, or eating different types of food. But this could be part of healing the gut. “Over time, eating regularly and more adequately will help restore natural digestive rhythms, improve the creation and release of digestive enzymes, and restore healthy gut bacteria,” Hartley said.
Carron emphasized the importance of working with an eating-disorder-informed dietitian during this time. “It’s normal to feel physically uncomfortable when starting to eat normally again, which can sometimes prevent an individual from pushing through and continuing the work,” she said. “However, once the body receives the message that it is safe and can allocate energy to digest again, the initial GI symptoms can go away. And eventually, the individual will most likely have even fewer GI symptoms and be able to tolerate more food/different types of food.”
When I started eating regularly, I experienced increased fullness and bloating, symptoms that made me want to go back to my disordered eating ways. They made it feel as though something was wrong with my body, which is why it’s so important to work with providers who know the impacts of disordered eating on digestive health and can help you identify and deal with the symptoms. I didn’t know as much about the digestive health effects then as I do now, but trusting my body to work through this adjustment was one of the first steps in finally listening to my body and embracing its needs again.
If you are struggling with an eating disorder or with disordered thoughts or behaviors regarding food and eating, please seek help. Call the National Eating Disorders Association Helpline at 1-800-931-2237 for support, reach out to a qualified medical professional, or, for a 24-hour crisis line, text “NEDA” to 741741.
Josey Murray, Contributing Wellness Writer
Josey Murray is a writer and editor passionate about well-being. She holds a Master’s degree in positive psychology from the University of Pennsylvania and a Bachelor’s degree in English and creative writing from Wellesley College. She has written for Women’s Health, mindbodygreen, Well+Good, and more.