The Connection Between Eating Disorders and Gut Health

Eating disorders significantly impact gut health, leading to digestive issues, altered gut bacteria, and long-term gastrointestinal (GI) complications. The relationship between the gut and the brain (gut-brain axis) means that disordered eating not only affects digestion but also mood, anxiety, and mental health. Understanding this connection can help improve treatment, symptom management, and recovery.

How Eating Disorders Disrupt Gut Health

·         Inadequate Nutrition & Malnutrition

o   Restricting food intake slows digestion, reduces stomach acid, and affects the ability to absorb nutrients

o   Low fiber intake leads to constipation and slowed gut motility

o   Vitamin and mineral deficiencies (like iron, magnesium, and B vitamins) impact gut function.

·         Altered Gut Microbiome (Dysbiosis)

o   The gut is home to trillions of bacteria that help digestion and immune function

o   Eating disorders, particularly anorexia nervosa and binge eating disorder (BED), disrupt gut bacteria balance, leading to bloating, inflammation, and poor digestion

·         Delayed Stomach Emptying (Gastroparesis)

o   In restrictive eating disorders, the stomach muscles weaken, slowing down food movement

o   Symptoms include nausea, bloating, acid reflux, and prolonged fullness after eating

·         Binge-Purge Cycle & Gut Damage

o   In bulimia nervosa, frequent purging damages the esophagus, stomach lining, and gut microbiome

o   Laxative abuse leads to dependency, dehydration, and long-term colon damage

Common Digestive Issues in Eating Disorders

·         Bloating and Gas

o   Disrupted gut bacteria and slowed digestion cause trapped gas and discomfort

·         Constipation

o   Low food intake, dehydration, and weak gut muscles lead to chronic constipation

·         Acid Reflux and Heartburn

o   Purging and malnutrition weaken the esophageal sphincter, causing reflux

·         Diarrhea and IBS-like Symptoms

o   Binge eating, purging, or reintroducing foods after restriction can shock the gut

·         Abdominal Pain and Cramps

o   The digestive system struggles to break down food properly

·         Research suggests that people recovering from eating disorders often experience Irritable Bowel Syndrome (IBS)-like symptoms, which can last months or even years.

The Gut-Brain Axis: How EDs Affect Mental Health Through the Gut

The gut and brain communicate via the gut-brain axis, meaning that gut imbalances can worsen anxiety, depression, and eating disorder thoughts.

·         Low Gut Bacteria Diversity = Increased Anxiety & Depression

o   The gut produces serotonin (the “happiness chemical”), but malnutrition reduces its production

o   Poor gut health is linked to higher anxiety, brain fog, and mood instability

·         Stress & Anxiety Can Worsen Gut Symptoms

o   Anxiety about food or body image triggers digestive discomfort (bloating, nausea, or cramps)

o   This cycle creates fear around eating, reinforcing disordered behaviors

·         Improving gut health can help with mental well-being, reducing both digestive symptoms and eating disorder related anxiety

How to Heal Gut Health in Eating Disorder Recovery

·         Gradual Food Reintroduction

o   Slowly reintroduce fiber-rich foods to prevent bloating and discomfort

o   Avoid highly processed foods initially to reduce gut irritation

o   Start with easily digestible meals like soups, smoothies, and cooked vegetables

o   Restoring the Gut Microbiome

§  Probiotics

·         Found in yogurt, kefir, sauerkraut, kombucha, or supplements (if recommended by a doctor)

§  Prebiotics

·         Feed good bacteria with bananas, oats, garlic, onions, and asparagus

§  Fermented Foods

·         Help restore gut bacteria diversity

§  Avoid sudden increases in fiber or probiotics

·         this can cause bloating or gas during the early stages of recovery

·         Hydration & Electrolyte Balance

o   Drink enough water, especially after long periods of dehydration or purging

o   Restore electrolytes (sodium, potassium, and magnesium) through broths, bananas, and coconut water

·         Managing Digestive Discomfort During Recovery

o   Eat smaller, more frequent meals to avoid overwhelming the gut

o   Chew food slowly and eat in a relaxed environment

o   Ginger or peppermint tea can help ease nausea and bloating

o   Light movement (like walking after meals) can aid digestion

·         Addressing Anxiety & the Gut-Brain Connection

o   Mindfulness & Deep Breathing

§  Helps reduce stress-related gut issues

o   Cognitive Behavioral Therapy (CBT)

§  Can retrain the brain to break the fear-pain cycle

o   Journaling Symptoms

§  Helps identify trigger foods and stress-related gut issues

When to Seek Medical Help

·         See a doctor or dietitian if your child experiences:
Severe bloating, nausea, or pain lasting more than a few weeks

·         Frequent vomiting or difficulty keeping food down

·         Unintentional weight loss despite eating more

·         Blood in stool or signs of malabsorption (pale, oily stools)

·         Chronic constipation that doesn’t improve with fiber or hydration

·         A gastroenterologist or eating disorder specialist can provide targeted treatment for gut-related issues