Eating disorders (EDs) are complicated; recovery, even more so. Not only can they be difficult to treat, but eating disorders (unlike some other mental health conditions) affect the body as well as the mind. I’ve experienced this firsthand, and I’ve had to heal my whole self in order to recover fully—including, surprisingly, my gut.
Throughout treatment programs, I’ve met fellow survivors with incontinence, who required low fiber diets, or who had been under doctor’s care for severe constipation. While my GI symptoms did not severely interfere with my daily life, I still needed to be prescribed medications for nausea and acid reflux.
Research shows that I’m not alone. Up to 98 percent of people who have an eating disorder meet the criteria for Functional Gastrointestinal Disorders (FGIDs), conditions that affect the functioning of any part of the digestive tract. The most prevalent among ED survivors is irritable bowel syndrome (IBS), a catch-all for digestive concerns that don’t meet the criteria of conditions such as Crohn’s disease or inflammatory bowel disease.
Gastrointestinal conditions can have many causes, but for people with EDs, their symptoms and habits over time can damage the entire digestive tract. Restricting food intake, bingeing, avoiding food groups, and purging—whether through laxatives or vomiting—all harm your digestion. Even if you’re not diagnosed with a full-blown eating disorder, the restrict/binge cycle often caused by chronic dieting can also cause harm.
How disordered eating can affect your gut
Pediatric gastroenterologist Mario Taño, MD, has witnessed the damage that disordered eating can cause in patients—even in young children. He says that when a person restricts their food intake (as with many forms of disordered eating), the gut immediately suffers. “We have two types of organs in our body: the vital organs and the non-vital organs,” he says. Your heart, lungs, and kidneys are considered “vital” (meaning you can’t live without them), while organs like those in the GI tract are considered less so. “If you don’t give yourself the appropriate amount of calories, there will be a prioritization of nutrients, and they go to the vital organs first.” Basically, severely restricting food starves your gut, which can lead to serious health problems.
Additionally, not eating enough food in general, or cutting way back on certain food groups, can disrupt your stomach’s good bacteria, says Philadelphia-based registered dietitian Theresa Shank, RD. This bacterial imbalance can affect one’s immune system and can contribute to symptoms of IBS or IBD.
According to Dr. Taño, behavior such as restricting or purging could lead to gastroparesis, where the stomach no longer properly contracts to break down food, delaying the digestive process. Gastroparesis can present itself as nausea or acid reflux after eating, or fullness well past a meal. Being malnourished can affect this, since your body is trying to preserve nutrients for more important functions, such as your circulatory system.
Further studies show that patients with eating disorders are also at risk for more severe conditions such as pancreatitis, ulcers, liver failure, colitis, and fatty liver disease. These conditions are often the result of malnutrition, purging, and consuming high quantities of fatty foods (as can happen when bingeing), which can be associated with anorexia, bulimia, or binge-eating disorder (BED). Another lesser-known effect of eating disorders is pelvic floor dysfunction, which is caused by chronic constipation associated with anorexia. Constantly straining to go to the bathroom can weaken the pelvic floor muscles.