Is your GI issue causing an eating disorder?

Monia Werlang, MD

Gastroenterology

Eating is one of life’s greatest pleasures, but if you struggle with gastrointestinal (GI) issues such as chronic constipation or irritable bowel syndrome, eating can be a chore. For some, GI issues may even lead to other nutritional struggles, like an eating disorder. Monia Werlang, MD, discussed the possible connection between GI issues and eating disorders.

“Eating disorders are not rare, and they can affect anyone,” said Dr. Werlang. “Most people tend to think eating disorders only happen in young women, but about one-third of eating disorders occur in men. Older women develop them, too. Eating disorders are also more common in patients with chronic illnesses and autoimmune conditions.”

She said eating disorders have become prevalent in individuals with GI issues, because individuals often try to change their diets to improve their symptoms, sometimes without success. These dietary restrictions can be overwhelming and isolating.

How might a GI issue lead to an eating disorder?

Someone with GI issues often will personalize their diet to identify culprits that may be causing the problem. This is usually done through elimination diets or restrictive diets. During these diets, an individual eliminates certain foods and then reintroduces them gradually and reassesses their symptoms. However, many people struggle to find a way back to an almost normal diet after eliminating foods, especially when these diets are attempted without guidance. This restriction can then lead to an unhealthy relationship with food, a lack of needed nutrition and possibly even an eating disorder.

“For example, an individual may be struggling with gut issues and goes on an elimination diet. Eventually, they discover the symptom culprit is gluten. However, they never reintroduce any of the foods they eliminated in their discovery of the gluten intolerance because they are afraid of their gut issues returning. This leads them into an unnecessarily restricted diet and an unhealthy relationship with food,” said Dr. Werlang.  

Other ways GI issues can cause disordered eating is when significant weight loss occurs for another reason like a chronic illness, inflammatory bowel disease, pancreatitis, or even major surgery. The pronounced weight loss can cause what is called “starvation brain,” when your relationship with food is changed by the weight loss itself.

What treatment options are available for this type of eating disorder?

Dr. Werlang said eating disorders are treatable, and a multidisciplinary approach is best. Individuals struggling with nutrition need a team approach to care to fully recover, restore nutrition, and move forward with a healthy body and mind. This can include a doctor, dietitian and psychologist.

“If you think you may be struggling with an eating disorder, talk with the provider you trust the most first – whether that be your primary care provider, your psychologist or therapist, your dietitian or another healthcare professional. They can then help you get started on your treatment and aid you in building out your multidisciplinary team,” said Dr. Werlang.