Q & A: What is the connection between iBS, Digestive Issues, and disordered eating?
Hi Abbie!
I’m so glad you have this newsletter as a part of your platform now. I’ve been following you on instagram for some time now, and it’s been life-changing for me. I’ve always prescribed to the belief that I eat the way I do for “health”, but what I’ve learned is there is so much disordered thinking behind it, and so much of it is wrapped up in my body image and desire to control my body. For background, I’ve considered myself a “healthy” eater for about 10 years. I followed a paleo-style diet for a while, and then mostly what would be called just “clean eating” (I only now put this in quotations after following you and understanding how harmful that phrase is!).
My question is about IBS — for me that’s meant stomach aches, bloating, cramping, gas, and often some constipation or diarrhea (sorry for all your readers who have to hear this!). For the last decade, I’ve attributed those symptoms to foods, and believed that if I avoided more processed foods or gluten or dairy that I could avoid the digestive issues. But now I’m struggling to incorporate more foods into my diet as I heal from what I realized has been disordered eating, and because my IBS symptoms are flaring, I’m finding myself in a cycle or negative self-talk and getting sucked back into the diet culture thinking. Help! I want to eat all the foods, but I’m struggling to with my cranky stomach. I know there is some sort of link here, but it’s really hard to push through this and I thought you might have some advice.
Thank you in advance!
Karla
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Hi Karla! I’m so grateful for this question - It’s such an important topic, and one that a lot of folks struggle with (as I’ll speak to in a moment). First, my standard disclaimer that these answers are not to be taken as medical or mental health advice, and do not constitute a provider-patient relationship.
So, there is a lot to unpack here. I want to begin by sending you so much compassion, and to also say that I can really empathize with your experience. I have spent a significant portion of my life with digestive issues, and on top of that experienced new and worsening ones with disordered eating. It’s a really hard thing to cope with, especially in this diet culture landscape of misinformation around health and wellness advice.
The first thing I want to note is that a lot of disordered eating behaviors begin as a result of having IBS or other digestive symptoms. This complicates things big-time! And it makes SENSE that a person would fall for the diet culture bullshittery about healing gut health through specific food regimens. In my case, I actually came into disordered eating through my gallbladder surgery and subsequent Celiac disease diagnosis. My intentions were completely rooted in self-care and I was focused on helping myself cope with horrible digestive symptoms; but, like many others, these behaviors spiraled into more and more restrictive choices over time. If you’ve had this experience, I want to say it is NOT your fault. Diet culture preys on autoimmune conditions and gut health as a means to sell certain elimination diets and “lifestyles” (actually, Karla, Paleo is often one of those!). It’s easy to become convinced that food will solve the problem, when in fact these diets (ahem, “lifestyles”, only cause more harm.
The second thing is that disordered eating, dieting, and “clean eating” (as you put it) can actually CAUSE digestive issues. Yes. In fact, one study showed that over 50% of those with disordered eating met the criteria for IBS, and 98% of those with disordered eating met the criteria for a functional gut disorder. This is because restrictive eating actually damages digestive function, and disrupts the microbiome and healthy bacteria in your gut. Beyond just the functional impact, a dieting mindset will mess with your relationship with food. It causes you to view certain foods as “good” and “bad”, which results in fear and stress around those foods that you deem “unhealthy”. Furthermore, the propensity for these folks to then seek out elimination diets causes even more harm. Often these elimination protocols are prescribed for way too long, and the proper support for reintroducing the foods (YES, you’re supposed to bring the foods back in!) isn’t provided. Elimination diets themselves can wreak havoc on digestive function. I see this most commonly show up as a fear of gluten or dairy without any true functional reason for avoiding these foods. In a later newsletter, I’ll do a deep dive into why avoiding gluten (when you don’t have Celiac disease) is not necessary, and actually harmful.
So let’s talk about that fear for a second. What we know is that emotional stress is actually a major cause of IBS and IBS symptoms. In fact, more so than food itself! So when you consider how your symptoms are manifesting right now, it’s so important to address your relationship with the foods you’re eating. If you feel discomfort, anxiety, fear, or stress about eating foods that you once labeled as “off-limits” (such as gluten, dairy, or the “processed foods” you mentioned), you are more than likely going to have gas, bloating, and stomach aches due to that psychological state you’re in when you eat them. We’ve seen countless studies show this effect. The stress itself leads to digestive problems, not the actual foods you’re eating. This is especially prominent when a person is outside of their normal food routine, such as out to dinner, or eating at a different time.
So, my tips for navigating this transition to a peaceful relationship with food, while coping with a cranky stomach:
Focus on getting into a neutral mindset about the foods you’re eating. Avoid the “good foods” / “bad foods” labels, and approach your meals with a relaxed perspective. Remind yourself that all foods are good foods, and that your body deserves nourishment. This will help to reduce stress around certain foods.
Similarly, try taking some deep breaths and eating in a calm, relaxed setting. This is called “rest and digest” mode, rather than “fight or flight”. It’s important to set your body up for more ease with digestion.
Keep focusing on incorporating a variety of foods into your eating. I know it’s so hard to navigate new foods, especially coming from a former dieting / disordered eating space, but variety is so crucial to regaining healthy gut function and digestion.
Remember, gas and bloating are NORMAL. They’ve been completely pathologized by diet culture, but honestly, it’s just part of your body’s functioning. We all experience it. The more you can normalize this, the less stress and fear you’ll attach to it.
Finally, I recommend finding a gastroenterologist who has experience working with disordered eating (and understands the impact on IBS / won’t prescribe an elimination diet). I also recommend working with a nutrition practitioner whose work is based in intuitive eating and health at every size. Having a team to support you is so helpful.
I really hope this helps. I think it’s a fantastic question, and one that many others with resonate with. Please let me know how it goes!
Xo, Abbie