IBS & Disordered Eating – Food Anxiety

Can elimination diets for IBS lead to disordered eating? If you’re worried about how much you think about food and your digestion this article might help.

Anxiety about food and IBS are very common in my clients, and after working with so many clients across the world I know how interlinked the two things are.

It’s not often clear which comes first; the anxiety about food triggering your symptoms, or the dietary restriction leading to stressful thoughts and obsessive behaviour around eating.

We do know there is a cross over between people with IBS, and people with disordered eating.

IBS is more common in people experiencing disordered eating

One study found over half of people with an eating disorder had symptoms of IBS. Most people with a type of eating disorder will have gut health issues due to overeating, undereating, vomiting or laxative use.

 There is a difference between conditions like anorexia nervosa, or bulimia nervosa, and disordered eating, but it’s often just small differences in how your symptoms meet the medical definition of eating disorders.

• To be diagnosed with an eating disorder by a doctor you must display certain signs and symptoms within defined timescales.
• In contrast, disordered patterns of eating are more common, but don’t always have a clear set of behaviours to define them. These collections of unhelpful thought processes, feeling and behaviours around food may have a still huge impact on your mental health.

If you’ve found a way to eat that helps you feel great and you’re comfortable around food you don’t need to worry.

But if food takes up a lot of your mind all day, every day, and you are beginning to get anxious about not fallowing all the rules, it might be time to look at your relationship with food. 

IBS and disordered eating may be more of an issue for some people than others.

This could be due to previous trauma, past life experiences, the severity of your IBS, other health conditions, or existing mental health conditions such as depression or anxiety.

If you’ve had an eating disorder in the past you may find your digestion changed and IBS may be more likely.

When should I be concerned about IBS and disordered eating?

Firstly it’s important to note, it is stressful making any changes to your diet.

So it’s normal to feel a bit overwhelmed with how to cook different meals. But when will it be an issue that needs further attention?

Do you feel a lot of anxiety around food that plays on your mind outside of mealtimes?

If you’ve been cutting things out of your diet to resolve your tummy problems you might start to feel like food is taking over your thoughts.

This might be because you’re still not sure what triggers your symptoms or where ‘you’re going wrong’, so you’re always puzzling to find a solution.

Or it might be because you have found a diet that allows you to eat without symptoms. Resolving your symptoms is top of mind, you want to stick to the diet that you know works.

But what about when this way of eating isn’t serving you any more?

What about when you can’t eat with anyone else, or you don’t eat out in case it messes with your diet.

It’s a careful balance of sticking to the diet you know helps your symptoms, and feeling relaxed about eating.

You may feel:

• Scared to eat out in case something triggers your symptoms
• Constant need to write in a food diary or use My Fitness Pal to log your diet
• You want to avoid eating with others in case you get an episode of IBS
• Embarrassed about how restrictive your diet has become
• Tired of people commenting on what you do or don’t eat

It can be a difficult line to walk to manage your symptoms without being too obsessed by your diet. If you feel food has become too prominent in your thoughts, and it’s affecting your life please seek help from professionals.

For some people therapy with a trained counsellor can help manage your feelings about food and dieting, alongside proper nutrition advice.

Restricting your diet can lead to gut problems

Depending on what you are restricting you may find it affects your digestion.

• If you are not eating enough food you may find you become constipated, or your digestive muscles weaken due to lack of sizable amounts of food going through the digestive tract. Constipation can lead to fermentation which may present as extra gas, pains, or bloating.

• If you have a diet with very limited variety your gut diversity will be reduced, which may impact on your immune health. We know that the bacteria feed on whatever we eat, so to get a broad range of microbes, we need to eat a varied diet, with lots of vegetables, fruits, pulses, grains and proteins.

Unfortunately many of these fibre rich foods can be frequent triggers for IBS symptoms, so you might be avoiding them, which can create a vicious cycle of increased symptoms due to imbalanced gut health.

The FODMAP diet cuts out fermentable carbohydrates which may trigger symptoms, but should only be followed for a short period of time.

It’s also important to understand that high FODMAP foods don’t cause your IBS, they may trigger symptoms, but they aren’t the cause.

When I work with my 1:1 clients we look at the underlying causes of your symptoms and figure out a plan to address them.

Should I go on an IBS elimination diet?

Sometimes it helps you to see if symptoms are affected by removing certain foods out of your diet for a limited period.

I may support my 1:1 clients to do this if I see a need for it. I will ensure they are getting a range of foods which make up for nutrients from the removed food groups.

If you’re not in a good place with food, the anxiety around implementing a new diet can be very challenging, especially something like the FODMAP diet.

It’s important to know what the underlying cause (or causes) of your symptoms are. Then we can start to make a plan. Cutting foods out may resolve symptoms, but if you’ve already cut out lots of foods and you’re still getting problems then you haven’t dealt with the underlying issue.

You need a plan. If you start cutting things out of your diet based on what last gave you symptoms it can be a little haphazard, and leave you on a very restricted (and boring) diet. It’s important to know what kind of food your eliminating, and why.

Coming out of an elimination diet is an important part of the trial, it’s good to re-challenge your body every now and again.

I help my clients do this in a measured way so we understand the results. If you need some help with bringing foods back into your diet again you can read my top tips in How to reintroduce foods after an elimination diet

IBS and disordered eating can create a vicious cycle

Anxiety about what to eat can make your symptoms worse, and you may be sick of spending so much time thinking about your digestion.

Many of my clients come to me feeling very confused about what to eat. If you want to free up some headspace for other things in your life let me help you find a diet that works for you.

If you’re struggling to navigate the options around IBS please contact me,  I’m an IBS nutritionist to arrange an appointment where we can discuss how I could help you.