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Content warning: This story contains sensitive details about eating disorders.

Dianne Chung’s eating problems started in middle school. Like many girls this age, the media’s fixation on women with very specific body types (read: skinny) made Dianne look a certain way. But there was more: she describes herself as a “sickly child” who always had trouble eating and digesting food. “A lot of my earliest memories are of throwing up because I was sick or had stomach pains, which was quite traumatic, so I didn’t really like to eat once I got older” , she says. It became common for Dianne to skip lunch at school, not only because of her struggles with food, but also because she wanted to save money. Dianne grew up with a single mother in a low-income household. “As eating was hurting me so physically, I figured it was best to save some money and have this help with expenses at home,” she says.

In middle school and high school, Dianne says her emotional and mental state crossed into eating disorder territory. Because her mother was often at work, Dianne took care of her own meals and in addition to lunch she often skipped dinner, as no one was around to tell her otherwise. She started exercising constantly, up to six hours a day. After school, she ate something small if she “couldn’t resist” the hunger pangs, but usually she worked out or went to bed early and slept until the next day. It lasted for years.

Dianne, now 25, is Korean and says that due to her cultural background and low-income upbringing, she didn’t grow up going to the doctor – the concept of health care is not wasn’t even really a thing in his family. “Even though I was in pain, it was not normal to go to the doctor,” she says. “I would just drink water or sleep.”

By the time Dianne arrived at the University of California, Berkeley, as a freshman, she had become so nervous about the “Freshman 15” that she ended up losing 15 pounds. It was only when Dianne began to experience nausea and dizziness, which she feared would affect her school work, that she decided to see a doctor. “I didn’t want to fail in school,” she recalls.

Dianne’s first visits to primary care physicians on campus were daunting: “I didn’t understand health care in the United States or what it meant to communicate your symptom. During the first three visits, Dianne didn’t even know when or how to talk about her problems. “There was a standard blood draw and then they were like, ‘Is there anything else you want to talk about? And I would feel so stuck trying to explain why I was there. My mind would just go blank.

Still, Dianne was determined to get help, so before a fourth visit, she tapped into her academic background and made a list of what she wanted to discuss. This was a turning point. “As soon as I arrived with my diary, the doctor responded with a series of follow-up questions, like what my diet was like and if I had ever seen a dietitian,” she says. From there, Dianne was diagnosed with anorexia nervosa with symptoms of binge eating and visited a gastroenterologist, who told her she had irritable bowel syndrome (IBS). She also met with a dietitian to guide her towards healthy eating habits and a therapist to help her get to the root of her eating disorders. She says cognitive behavioral therapy played a huge role in her recovery: “It was really about changing the mindset behind my IBS symptoms and my relationship with food, where now I no longer have shame.”

It is almost shocking that people with eating disorders also suffer from bowel disorders. According to a study 2019 Posted in Nutrients, 98% of patients with eating disorders meet the criteria for at least one functional gastrointestinal disorder (FGID), the most common being IBS. But one does not necessarily cause the other. Alexandra Fuss, PhD, a psychologist specializing in digestive health at Yale New Haven Hospital says it’s a “chicken-or-egg situation” depending on the patient’s presentation. “Disordered eating behaviors can put a great strain on the body through significant nutritional deficits and physical stress from compensatory behaviors such as vomiting, excessive use of laxatives, or excessive exercise, which in turn can lead to complications of gastrointestinal motility, erosions of the esophagus, increased inflammation, etc.,” she explains.

On the other hand, some people, like Dianne, first develop IBS symptoms such as stomach pain or difficulty digesting food and change their eating habits accordingly. “When people start to equate food with their symptoms, it can lead to a fear of eating, restricting certain food groups, and leading to total avoidance of certain foods or binge eating,” explains Lynn O’Connor, MD, Director of Colon and Rectal Surgery in New York. “This type of relationship with food can cause anxiety around food and psychological stress, which can lead to changes in the gut, and even change the composition of bacteria in the gut, which can contribute at SCI.” In other words, disordered eating habits can increase your chances of developing a gastro health problem, and the reverse is also true.

John Damianos, MD, an internal medicine physician specializing in gastroenterology at Yale New Haven Hospital, says that’s, in a way, a pretty natural response. “If any of us had a stimulus that bothered us, we would avoid it,” he says. “But with abnormal and sustained eating habits, this can eventually develop into true eating disorders such as anorexia nervosa, bulimia nervosa and avoidant/restrictive food intake disorder (ARFID).”

“Disordered eating behaviors can put a lot of strain on the body.”

In the case of anorexia, defined as abnormally low body weight due to an intense fear of weight gain and/or a distorted idea of ​​weight, “people often experience constipation, gas, and bloating. due to reduced bowel activity and delayed emptying”. of not eating enough for long periods of time,” explains Jenna Volpe, a dietician based in Round Rock, Texas. “Food is not ingested in large enough volumes to simulate the digestive system and the smooth muscles responsible for digestion and gut motility, so the gut slows down.” For those with bulimia, which can lead to food purging in the form of self-induced vomiting, laxative abuse, and over-exercise, food that Is being ingested either does not make its way through the entire digestive tract (in the case of induced vomiting) or is rushed through the system too quickly (in the case of laxatives), which can disrupt the natural digestive biochemistry. Dr. Damianos adds that orthorexia nervosa, or a pathological obsession with healthy eating, has been suggested as an emerging disorder, and it can also lead to symptoms of IBS.

Just ask Erin Decker, 31. Although she doesn’t know what started first, her disordered eating habits or her IBS symptoms, she calls them a “natural consequence” of being a relatively anxious and highly stressed person. Studying to become a dietitian strengthened her orthorexia nervosa, and she decided to seek help once it began to affect her relationship with friends and family. Today, as a Registered Dietitian who works with clients with eating disorders, she says, “Taking care of myself is so important. I’m also a new mom, so it’s easy to lose track of time and forget to eat regular meals or ask for help. I notice that my IBS symptoms intensify when these needs are not met. She adds that the mantra “Don’t let perfection get in the way of the best” is also helpful.

Emily R., 28, says her messy eating habits started first, as she battled anorexia for 12 years. Along the way, she began to experience prolonged periods of constipation. “I began to realize how time and space-consuming thinking about food and my bowel movements was – so much that I couldn’t be a friend or partner – and I knew I had to ask for help. help,” she recalls. Emily was told she had IBS-C, a type of IIS where constipation is the main symptom. She is now actively seeing both a therapist and an eating disorder dietician, in addition to limiting stress, taking a magnesium supplement and drinking spearmint tea, and, no kidding, saying nice things to his stomach. “It sounds hokey, but don’t hit it until you’ve tried it,” she adds.

Dianne says that through the combination of her own therapy and working with a dietitian, she now considers herself a foodie. “I think about the time I lost enjoying different foods from different cultures, and now I’m always looking for recommendations. It became an adventure to try new things with my partner and my friends. I never would have believed this in elementary school, but now food is an art form that I really enjoy.