Can elimination diets for IBS lead to disordered eating?
It’s not normally clear which comes first, the anxiety about food triggering your symptoms, or the dietary restriction leading to stressful thoughts and obsessive behaviour around eating.
But 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 the people with an eating disorder had symptoms of IBS.
Of course, there is a difference between conditions like anorexia nervosa, or bulimia nervosa, and disordered eating.
- 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 less defined, but more frequently found. These collections of thought processes, feeling and behaviours may have a still huge impact on your mental health.
This might sound a bit scary, but if definitely doesn’t mean that if you’ve got IBS, and you’re cutting certain foods out of your diet you will develop an eating disorder.
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.
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 your mental health.
If you’ve had an eating disorder in the past you may find your digestion has 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.
So we need to look at the underlying causes of your symptoms.
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.
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 to arrange an appointment where we can discuss how I could help you.
Hi I'm Anna Mapson, registered Nutritionist (mBANT, CNHC). I help people with IBS, gut health and digestive issues.
I can help you to:
- understand your digestion better, so you recognise your triggers
- eat a well balanced diet, with tasty meals that are simple to prepare
- develop healthy, sustainable habits for life
“Anna is amazing! I feel totally transformed"
To find more about 1:1 nutrition consultations or my group membership see my IBS Diet support page