Digestive health after eating disorders

Eating disorders are a complex group of conditions that affect many Australians. They include Anorexia Nervosa, Bulima Nervosa, Binge Eating Disorder, Other Specified Eating and Feeding Disorders (OSFED), Avoidant/Restrictive Food Intake Disorder (ARFID) and many more. Men and women of all ages can be affected by eating disorders; approximately one million Australians experience an eating disorder at anytime. Eating disorders are not a lifestyle choice or a cry for attention, they are a health concern that needs to be taken seriously. 

Recovering from an eating disorder requires a multi-disciplinary team of doctors, psychologists and other health practitioners. Once recovered from an eating disorder, many people continue to experience gastrointestinal symptoms. These include heartburn, indigestion, burping, nausea, bloating, constipation, or pain with a bowel movement. Research indicates up to 98% of people with eating disorders experience functional gastrointestinal disorders such as IBS at some point in their life, most commonly in the first year after recovery, but it is common for these symptoms to occur up to 10 years post-recovery. 

The digestive system after an eating disorder

Eating disorders affect and cause changes in the way food moves through the gastrointestinal system (gut motility), sensitivities, impaired satiation response (knowing when you’re full),  and delay food moving from the stomach to the small intestines (delayed gastric emptying). This is due to ​​the stress placed on the digestive system from restricted food intake, binging, avoiding food groups, and purging. Even if you’re not diagnosed with an eating disorder, the restrict/binge cycle often caused by dieting or disordered eating can cause stress and harm. 

The digestive system (also known as the gastrointestinal system or ‘gut’) is home to the gut microbiome. A collection of about 100 trillion bacteria, archaea, fungi, parasites, and viruses that reside within the gastrointestinal tract. Their job is to keep you alive. They do this by breaking down food into individual nutrients for the body to use, maintaining the structure of the digestive system, supporting the immune system, and creating the right environment for neurotransmitters to be made and for the immune system to live. The gold standard gut microbiome has a large colony, diverse with different species to support overall health and wellbeing. Because food is the fuel of our body and the gut is connected with so many bodily systems, an imbalance of the gut microbiome has been associated with many conditions from IBS, to inflammation, an increased risk of cardiovascular disease, insulin resistance, and poor bowel movements (constipation or diahorrea). Specific dietary patterns can affect the amount and diversity of the gut microbiome. For example, where an individual has followed a vegetarian or vegan eating pattern for a period of time before requiring oral supplements or nasogastric feeding with products based on cow’s milk, there is a rapid change the species that make up the microbiome.  Current research indicates there are differences in the microbiome of those who have experienced an eating disorder compared to those who haven’t. But there are inconsistencies in the specifics of these differences, this will be investigated as further research emerges. The good news is however, the gut microbiome can be changed and gut health improved.

How can a clinical nutritionist help?

From a nutritional medicine perspective, it is important to support the movement of food through the digestive system and the balance of the microbiome with pre-biotic foods and a diet high in a variety of fibers. We can do this in a way that doesn’t involve the restriction of food groups to support a healthy relationship with food. Supplementation with specific strains of probiotics has demonstrated improved gastrointestinal symptoms and immune function. By taking a holistic view, I can also assess nutrient intake to ensure all systems are adequately supported.

If you are experiencing an eating disorder, please contact the Butterfly Foundation or your doctor for support.