Digestive issues are one of the most prevalent side effects for individuals with eating disorders, no matter the type.

In fact, one study suggests that up to 98% of people with eating disorders meet the criteria for functional gastrointestinal disorders – conditions that affect the functioning of the digestive tract and can cause symptoms like stomach discomfort, bloating, acid reflux, and changes in bowel habits. Even though various factors contribute to functional digestive issues, the presence of disordered eating behaviors such as food restriction, binge eating, and purging can all have harmful effects on one’s digestive health.

It’s important to note that people with eating disorders will experience digestive issues and other symptoms of disordered eating differently. Here, we will explore the connection between eating disorders and digestive issues, as well as how to navigate digestion while in recovery.

Understanding Digestive Issues and Eating Disorders

Digestive issues often occur in individuals with a history of disordered eating behaviors, including (but not limited to) extreme food restriction, rigid food rules, and binging/purging episodes.

When someone severely restricts their food intake or engages in selective eating behaviors, they often fail to consume a balanced diet that provides enough essential nutrients. This can lead to deficiencies in vitamins, minerals, and other nutrients vital for proper digestive function as well as a slowed metabolism in certain individuals, which can result in difficulties digesting food.

Commonly seen in those with anorexia nervosa, prolonged and severe food restriction may cause the digestive process to slow down. For some, this may lead to a condition known as gastroparesis, a digestive disorder characterized by delayed emptying of the stomach contents, leading to symptoms such as nausea, bloating, and abdominal discomfort. Prolonged fasting may also lead to muscle wasting, including the muscles of the GI tract, which can further impair food digestion.

Moreover, purging behaviors like self-induced vomiting or laxative misuse can disrupt the normal functioning of the digestive system as well. Frequent vomiting can damage the esophagus and tooth enamel as well as cause electrolyte imbalances in the body, which is essential for proper muscle and digestive functioning. Purging in the form of laxative abuse can also cause severe dehydration and electrolyte imbalances, which may lead to constipation and other digestive concerns.

Most Common Digestive Issues in Eating Disorders

The most common digestive issues experienced by those with eating disorders include:

• Gastroparesis: Delayed emptying of the stomach contents, leading to symptoms such as early satiety, bloating, and nausea
• Bloating and gas: Caused by altered digestion patterns and/or reduced abdominal muscles and fat
• Nausea and vomiting: Associated with gastroparesis or purging behaviors which can irritate the stomach lining and disrupt normal digestion
• Constipation: Resulting from inadequate intake of fiber and fluids, as well as disrupted gut motility due to severe food restriction and/or purging behaviors
• Early satiety: Feeling full quickly and/or feeling full all the time, which may be related to gastroparesis
• Acid reflux: Characterized by the backflow of stomach acid into the esophagus, leading to heartburn, chest pain, and regurgitation, and is frequently observed in those with repeated self-induced vomiting behaviors
• IBS-type symptoms: Often exacerbated by irregular eating patterns and dietary restrictions in eating disorders, may include abdominal pain, cramping, diarrhea, and/or constipation

Importantly, these digestive issues can significantly impact one’s recovery and nutritional status, which is why proper medical and nutritional intervention is such an important aspect of the treatment team.

How to Navigate Digestive Issues in Recovery

During the initial stages of eating disorder recovery, adjusting to eating the right amount of food prescribed by your dietitian or nutritionist can be tough, especially with the lack of hunger and fullness cues many individuals often experience. However, although meeting the recommended food intake can feel challenging at times, skipping meals or delaying following meal plans may only exacerbate digestive symptoms as the gut remains undernourished.

For people with eating disorders, the feeling of being full is often misinterpreted as feeling “fat” or having weight gain, which can highly complicate the emotions surrounding recovery and motivation. The good news is that digestive issues do improve over time with proper nutritional rehabilitation, weight restoration, and elimination of disordered eating behaviors.

But, in the meantime, when digestive issues are at their peak during recovery, here are some practical tips to manage and ease stomach discomfort following a meal:

• Drink water: Staying hydrated will help break down and absorb nutrients as well as prevent constipation, but avoid excessive water consumption so as not to replace food with water
• Practice relaxation techniques: Engage in deep breathing, meditation, gentle yoga, or other relaxation techniques after meals to promote relaxation and reduce stress
• Avoid lying down immediately: Remain upright after meals to allow gravity to aid in digestion, reducing the likelihood of experiencing acid reflux and stomach discomfort
• Wear loose-fitting clothes: Choose comfortable clothing that isn’t too tight to reduce feelings of bloating and stomach pain during and after meals
• Distract yourself: Engage in hobbies and self-care activities to distract yourself from fullness and/or stomach discomfort

Additionally, having community support can be a highly beneficial resource for individuals struggling to navigate digestion and other concerns throughout the recovery process. Our RecoVERY Community is designed to be a safe space for people with all types of eating disorders to gain valuable recovery skills through continuous community support, valuable psychoeducation, virtual meal support groups, and more!

Join the community for free today to see how it can help transform your recovery journey.

Looking for more support in your recovery? Schedule a free, no-commitment consultation with our team to learn more.