By: Natalie Colantuono

If you haven’t seen someone reference their morning apple cider vinegar shot lately, then you may not be very active on social media.

It seems that the diet industry is not only aiming at weight loss or wellness, but is attempting to serve as the “gut healing” guru as well (self-proclaimed, of course).  A focus on gut health has also entered the realm of fitness bloggers. More and more health influencers are speaking up about their poor gut health, whether it’s Irritable Bowel Syndrome (IBS), possible food intolerances, constant bloating or GI distress.

How Can You Really Live Your Best Life?

As a current dietetics student who has struggled with severe disordered eating in the past, I find myself being hyper-vigilant of the diet culture that is immersed in health and wellness dialogues. Top social media influencers, such as Kim Kardashian promote detox teas,  describe what a diet should look like to “live your best life,” create a culture with an ever-increasing fixation on the food they eat along with the exercise they engage in. A history of dieting is the most important predictor of developing an eating disorder (or severe disordered eating behaviors).¹ I thought to myself – what’s going on here?

Is it really a coincidence that those who commonly promote restrictive, rigid, and disordered eating patterns are the same ones that complain about constant GI distress? There must be a link.

Approximately  12% of the population suffers from IBS, with women being two times more likely than men to have the disorder.² Similarly, there are about double the number of women that are diagnosed with eating disorders than men – a statistic that parallels IBS but offers no more than a slight association.³ Individuals with eating disorders also tend to share the same fundamental psychological challenges as those with a Functional Gastrointestinal Disorder (or FGID, an umbrella term encompassing IBS and other disorders). These include anxiety, depression, and overall poor body image. When stress around food and exercise is so high, it only makes sense that those with disordered eating behaviors may be experiencing these same psychological challenges, at least to some degree.

What’s the Connection?

The physiological consequences of eating disorders include constipation with inadequate food intake, stomach pain, bloating, nausea/vomiting, and even intestinal obstructions. These complications noticeably mirror many symptoms of those with FGID. In fact, in one study, it was found that about 64% of individuals with eating disorders met the criteria for IBS.⁴ Compared to the 12% that suffer from IBS nationally, 64% is a concerning and sizable occurrence. Another study also found that individuals with any FGID had a 16% higher likelihood of having an eating disorder than those with no present GI disorder,⁵ showing another possible correlation.

But what about those without diagnosed eating disorders that are experiencing elevated amounts of GI distress? How does this apply? I needed to form a bridge.

A study conducted by SELF magazine and University of North Carolina found that about 65% of women between 25-45 years of age report having disordered eating behaviors.⁶ Compared to the 13% of women diagnosed with an eating disorder in the U.S., this is a fairly large gap of women engaging in unhealthy food behaviors that do not have a clinical diagnosis that fits the DSM.³

Perhaps the most problematic part of disordered eating habits – besides their damaging impact on the mental & physical health– is that they are often categorized as “part of the health journey.” This culture-wide assumption makes it substantially more difficult to see that the eating behaviors, and the mindset they are rooted in, may be hurting much more than helping.

Maybe It’s Not the Food

Instead, so many continue to turn to the foods that they are eating – the gluten, the dairy, the grains – to blame for their constant state of distress.

For the majority, the food restrictions become unsustainable long term. The forbidden foods are eventually reincorporated back into the diet, causing feelings of guilt and disappointment, and the GI symptoms continue without finding a root cause. Thus, a never-ending cycle is created: cutting out foods, experiencing shame in food decisions when the diet fails, and ultimately resulting in a series of disordered eating habits.  If it wasn’t the gluten, it must be the dairy. – the pattern continues.

Looking at the 60-billion-dollar diet industry and the ever-growing population of unqualified health and fitness influencers, it’s not surprising that individuals are misinformed about true healthful eating. Cutting out food groups, restriction, labeling foods as good/bad, and just overall guilt around food choices have become too widespread.

Promoting Disordered Eating

Disguising disordered eating patterns as “part of a healthy lifestyle,” twists concerning issues into quirky hashtags by unqualified influencers. Future research on disordered eating habits, GI distress, and even incorporating the role on the gut microbiome and the gut-brain connection is imperative in developing additional research on this topic.

There needs to be more research done on the cause and effect relationship between disordered eating and IBS symptoms.  Available research supports that these detrimental behaviors and GI distress are interconnected. While engaging in disordered eating does not mean that an individual has a diagnosed eating disorder, all individuals with diagnosed eating disorders engage in disordered eating.  Disordered eating of any extent may be the link to the undesirable GI symptoms (rather than merely the presence of a specific eating disorder diagnosis).

And to the products on the market that claim to be “gut healing,” being sold by the same companies that are embedded in diet culture (and likely contributing to disordered eating habits) … I sense a bit of hypocrisy.

Natalie Colantuono is a current Nutrition and Dietetics student at the University of Pittsburgh. Her areas of interest in dietetics include eating disorder recovery, Health at Every Size, intuitive eating, and overall promoting a healthy relationship with food and your body.

^{Connect with her on Instagram and LinkedIn.}

References

1. Golden NH, Schneider M, Wood C. Preventing obesity and eating disorders in adolescents. 2016; 138(3). doi:10.1542/peds.2016-1649
2. Irritable Bowel Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/all-content. Published November 1, 2017. Accessed June 4, 2019.
3. Risk Factors. National Eating Disorders Association website. https://www.nationaleatingdisorders.org/risk-factors. Published August 3, 2018. Accessed June 4, 2019.
4. Perkins S, Keville S, Schmidt U, Chalder T. Eating disorders and irritable bowel syndrome: is there a link? Journal of Psychosomatic Research. 2005;59(2):57-64. doi:10.1016/j.jpsychores.2004.04.375.
5. Porcelli P, Leandro G, De Carne M. Functional gastrointestinal disorders and eating disorders. Relevance of the association in clinical management. Scandinavian journal of gastroenterology. https://www.ncbi.nlm.nih.gov/pubmed/9669626. Published June 1998. Accessed June 4, 2019.
6. Reba-Harrelson L, Von Holle A, Hamer RM, Swann R, Reyes ML, Bulik CM. Patterns and prevalence of disordered eating and weight control behaviors in women ages 25-45. Eating and weight disorders: EWD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612547/. Published December 2009. Accessed June 4, 2019.