Several years into my work as a nutrition therapist I found myself really grappling with a clinical dilemma. Many of my clients were not only suffering from an eating disorder but they were also suffering from pretty severe digestive issues. And these digestive issues were not only complicating their recovery but they were seriously impacting my clients’ quality of life. In fact, many clients who had made tremendous strides in their eating disorder recovery were suffering with digestive symptoms that other clinicians had promised would go away once they got better from their ED.
So I delved into the research, participated in a year long integrative nutrition therapy training, exchanged supervision with colleagues who specialize in digestive health, attended workshops, and I thought A LOT. In fact, I want to make a big shout out to my friend and colleague Lauren Dear who is an amazing digestive health dietitian and has taught me so much. (Sidebar: I have the honor to speak with Lauren at three upcoming conferences. See below!)
All of this study (and continued study!) led to a series of talks on the intersection of EDs and digestive disorders that I have and will be giving in 2017. And with enthusiasm, I’m writing to let you know that I am also in the process of developing an online self-study course on the topic. I will have it ready this spring and can’t wait to share it with you. I believe in my heart it will help you feel more capable in helping your clients heal. Below I’ll provide links with upcoming places I’ll be speaking on this important topic. But for now, I’d like to share some juicy tidbits!
- Up to 98% of clients with eating disorders have a functional gut disorder (FGD) (Note: FGDs are things like Irritable Bowel Syndrome, gatric reflux, bloating, constipation, and diarrhea (to name a few).
- People who suffer from FGDs and EDs share the same underlying mental health challenges- namely anxiety and depressive disorders
- These mental health challenges can lead to digestive symptoms that can perpetuate long after the ED symptoms have resolved
- EDs can actually cause FGDs and FGDs can make a person vulnerable to the development of an ED. This means it is BOTH the chicken and the egg.
- Childhood GI issues are a key risk factor for the later development of an ED
- Both EDs and FGDs negatively impact body image. A person who suffers from both has a double whammy to contend with!
- Anorexia Nervosa changes the gut microbiome by deceasing bacterial diversity. Lower numbers of bacterial diversity are associated with greater levels of eating disorder psychopathology.
Key Take Home Messaging
There are many non-harmful interventions to try with clients.
- Most if not all behavioral interventions that support ED recovery will also support digestive health. Root out remaining ED behaviors as most will reinforce negative GI symptoms.
- Sensitive systems require CONSISTENCY & BALANCE.
- A stressed out person will likely have a stressed out gut. Help clients embrace hypnotherapy, meditation, deep breathing, guided relaxation. The relationship between head brain and gut brain is REAL!
- Food variety improves the gut microbiome and is a key ingredient to ED recovery.
- The goal is to include as many foods as possible for mental, emotional, and psychological well-being.
- Integrate the use of digestive enzymes, probiotics, and well-researched supplements to help manage symptoms.
- Fuel healthy bacteria by integrating fermented foods and drinks.
- Incorporate a stool or squatty potty for more anatomically supported elimination (ie the squat position makes it way easier to poop!).
- Eliminate “diet foods” as they contain a lot of additives that worsen digestive symptoms and are often a culprit in the ED
- Play with changing the texture of foods rather than eliminating them all together