A Dietitian’s Digestive Toolkit for Eating Disorder Recovery

Tips to help soothe digestive issues in eating disorder recovery

It’s very common in the initial stages of eating disorder recovery to struggle with digestive discomfort. In my role as a Dietitian supporting clients in the re-nourishment process, we frequently discuss gastrointestinal (GI) symptoms such as bloating/distension, abdominal pain, premature fullness, and constipation. This is also supported by the current body of research we have on eating disorder recovery – one prospective study investigating this link found that 90% of participants reported abdominal distension and 96% reported premature fullness during the re-nourishment process. For many of my clients with an eating disorder, these digestive issues can complicate recovery and also have a significant impact on their quality of life. In addition, symptoms like bloating and distension often trigger more challenging body image thoughts, only adding fuel to the ED voice. 

The truth is that there is so much overlap between eating disorders and digestive issues / disorders. In fact, research has demonstrated that up to 98% of individuals with an eating disorder also have a functional gut disorder (a classification encompassing syndromes such as IBS, gastric reflux, bloating, constipation, and diarrhea).  Individuals struggling with eating disorders and stomach issues/digestive disorders also often share common underlying mental health challenges such as anxiety and depression. It’s a bit of a chicken or the egg scenario, because the presence of a functional gut disorder can make an individual more vulnerable to develop an eating disorder, but the presence of an eating disorder may result in the development of a functional gut disorder!  

When we are in the first phase of eating disorder recovery, I try not to sugar coat it – I tell my clients they should prepare to experience some digestive discomfort. The reality is that the gut has suffered a nutritional trauma – whether it is restriction, bingeing, chaotic eating patterns, or the use of other disordered eating behaviors, our digestive system has been disrupted and stressed, and it needs time to rebuild and heal, just like the rest of the body. Knowing what to expect and building your digestive health toolkit can help you to feel confident navigating the first phase of eating disorder recovery. 

Below are a few of my top tips to help soothe digestive discomfort in eating disorder recovery: 

1. Build in daily self-care practices for stress management

Stressed out people often have stressed out guts, and recovery is stressful! Interventions such as meditation/prayer, gentle yoga, and deep belly breathing or box breathing can help transition our body’s nervous system into “rest and digest mode”, thus improving our body’s ability to break down and absorb food. 

2. Support your Vagus Nerve

Your vagal nerves are the nervous system “superhighway” between the brain and the gut, and play a large role in regulating digestive processes. Stimulating the vagal nerves before eating can support the body in preparing to eat while minimizing GI distress. Your Vagus nerve is connected to your vocal cords and the muscles in the back of your throat, so humming or singing can help with stimulation. Gargling also works too – I often suggest this one, because if anything, it makes you giggle which again, relaxes our nervous system!  

3. Cook vegetables where possible

Sometimes raw fruits and veggies can be hard on our digestive tract because it requires a lot of work for the body to break down the fibers. Try roasted or steamed veggies or puree them into a vegetable soup to support the digestion of these nutritious foods.   

4. Eliminate diet foods

Low sugar or no sugar diet products often contain ingredients like inulin and sugar alcohols, which can worsen digestive symptoms such as bloating, abdominal cramps, and diarrhea. 

5. Peppermint

Either as a strongly brewed peppermint tea or enteric coated capsules, peppermint has been shown to calm and relax the muscles of the digestive tract, improving digestion and allowing gas to pass through.  

6. Ginger

This root has natural “prokinetic” properties which encourages food to move at a healthy rate through the digestive tract. Adding ginger tea, cooking with ginger root, or eating a few ginger chews before or after a meal can help those struggling with early fullness in recovery.  

7. Heat packs/Hot water bottles

Not only can you get cute and cozy covers for your hot water bottles, but placing something warm on the tummy during and after meals can help relax the stomach and reduce pain.

8. Consider supplements

Adding Magnesium can help alleviate constipation and reduce stress, and a high-quality probiotic may help with supporting a healthy gut microbiome, which we know can be impacted by eating disorders, particularly anorexia. Discuss with your dietitian and treatment team what formulations and doses may be right for you. 

9.The physicality of pooping

Body positioning can play a key role in making elimination easier, especially if you’re feeling constipated. Consider adding a stool or a Squatty Potty for better bathroom breaks!

10. Consistency with your nutrition plan

When it comes to moving through digestive discomfort, consistency and balance are the name of the game. For stressed out and sensitive systems, a predictable routine can be so helpful. This will help regulate digestive processes and support healthy motility because the body will begin to develop a predictable digestive routine and settle into a rhythm.  

If you are battling an eating disorder and struggling with digestive symptoms – know that I see how hard you are working. It can be so challenging to hold fast to your recovery plan and fight back against the oh-so-convincing lies of diet culture and the wellness industry. Stay the course. Day by day. And know I’m here for support!