As a registered dietitian at Integrated Eating, I believe that:
food is healing
food is fuel
food is pleasure
and all foods fit into a balanced diet.
But what happens when certain foods begin to hurt us? How does this ultimately affect our relationship with food? And what if we are already in recovery for an eating disorder and faced with medical reasons to restrict certain foods from our diet?
There are many chronic medical conditions that involve being cautious of what or when to eat or even more limiting or eliminating certain foods. For example, those diagnosed with Celiac Disease must avoid gluten. Someone with an allergy to nuts must avoid all nuts, perhaps even foods made in a facility containing nuts. A person struggling with a lactose intolerance must be knowledgeable of what foods contain lactose, so they know when to take a Lactaid. Someone struggling with irritable bowel syndrome (IBS) may or may not be aware of what foods trigger their gastrointestinal (GI) symptoms, leading to constant worry and anxiety at mealtimes. These types of preoccupation can bring on disordered eating thoughts and behaviors. For those navigating recovery who find themselves managing chronic medical conditions, allergies or intolerance- this is even more difficutl.
When chronic conditions come into the picture, food restrictions may predispose us towards disordered eating or eating disorder recovery efforts may be challenged. We may begin, for example, to choose foods based on GI tolerance rather than listening to our intuitive cues. Maybe our body is wanting ice cream, but we are too anxious about how it may affect our stomach, so we opt for something that seems “safer” and won’t upset our stomachs.Because of this, ice cream stays on our mind and preoccupies our thoughts. The fear of GI distress outweighs our desire for ice cream, and we subconsciously begin seeing ice cream as a “forbidden” or “unsafe” food, leading to restriction. Or perhaps someone with IBS begins an elimination diet, avoiding gluten, dairy, eggs, and other foods. Food becomes the problem and avoiding it becomes the solution. And in a moment our “all foods fit” model is overrun by our chronic medical conditions.
Research has shown that those suffering with chronic medical conditions, including GI disorders, are at a higher risk of developing disordered eating and eating disorders (1,2). Those struggling with these illnesses typically put more focus onto their diets than the average person and will avoid certain foods to avoid unpleasant symptoms. While we know the etiology of eating disorders are multi-factorial, the emphasis of diet due to related conditions can increase someone’s likelihood of developing an eating disorder. In addition to preoccupation with food, those with IBS and inflammatory bowel disease (IBD) also identify with body shame (1).
Negative body image may be tied to a decreased self-esteem and self-worth, putting someone at risk for developing an eating disorder. What’s more, those already in recovery for an eating disorder can find themselves struggling to find balance in taking care of their health while advocating for their reocoveries.
When food brings us physical discomfort, or dis-ease to the body, the relationship with food may be affected. Just because a chronic condition may warrant the avoidance of some foods, it does not mean these foods are “bad.” It is important to work with a dietitian experienced in disordered eating and eating disorders to help you rebuild your relationship with food while taking into consideration your chronic condition.
Quick, V.M., Byrd-Bredbenner, C., Neumark-Sztainer, D. Chronic illness and disordered eating: a discussion of the literature. Adv Nutr. 2013:4;277-286.
Satherley, R., Howard, R., Higgs, S. Disordered eating practices in gastrointestinal disorders. Appetite. 2015;84:240-250.