There is no denying that having IBS is a difficult challenge. But what happens when a person who has IBS is also trying to recover from an eating disorder (ED)?
It is common in people with IBS to follow a low FODMAP diet to ease their GI symptoms. But for people who also have an eating disorder, it can be a very restrictive diet and reinforce that “bad” foods exist. This mindset can trigger psychological distress and lead to disordered eating habits such as skipping meals, binge eating, and purging, taking them steps back from their recovery. These habits can also prompt IBS symptoms to pop up due to the physical and mental stress.
According to Kimberly Harer, MD, ScM from the University of Michigan Medicine, people with GI disorders, such as IBS, are at a higher risk for disordered eating. Approximately 23% of patients with GI disease have disordered eating habits,
“Disordered eating is a way to avoid or prevent uncomfortable and distressing symptoms, such as bloating, abdominal pain, constipation, and/or diarrhea,” said Dr. Harer in an interview with Gastroenterology and Hepatology Journal. “Disordered eating turns into an eating disorder if the behavior, such as skipping meals and avoiding certain foods, turns severe and drives to body dysmorphia.”
It’s important for nutritionists and dietitians to be aware of their patients’ behavior patterns when it comes to food. It’s especially essential when treating those who have a history of an eating disorder. If they notice that the patient is practicing in disordered eating habits, steps must be taken to address the issue quickly. Once a person starts having a healthy relationship with food and has managed their eating disorder, only then can they safely treat IBS symptoms through a low FODMAP diet.
Managing the combination of IBS and an eating disorder is a team effort, requiring the help of a dietitian/nutritionist who specializes in eating disorders, a therapist, and a physician. The healthcare team is more effective if there is trust between them and the patient. Many times, an individual with an eating disorder may not be as open about his or her lifestyle and eating habits. While this lack of trust initially is a common occurrence, the care team won’t be able to properly see what is causing the IBS symptoms and help.
While there is a consensus in the healthcare community that there still needs to be more research on the link between eating disorders and IBS, the best course of action is to be consistently honest with the healthcare team. Those who don’t have a care team and are suffering from an eating disorders should seek one out by visiting the National Eating Disorder Association’s website, which has a map tool to help find a team member locally.