Gastrointestinal Effects of Eating Disorders Revisited

Eating disorders are primarily psychiatric disorders. The obsessive thoughts about food and weight combined with the shame associated with body image and negative self-esteem are the heart of these illnesses.

However, all eating disorder symptoms have medical consequences. The effects of chronic under and/or over-eating, purging, laxative/diuretic/appetite suppressant use all wreak havoc on overall health. Chronic medical illness is very rarely a motivating factor in recovery since the underlying thoughts are not logical but obsessive in nature. Through the recovery process, it’s critical to manage and maintain health as much as possible.

The worst and most common medical conditions caused by eating disorders are gastrointestinal. A few of these problems are the most common and also intractable.

Long-standing food restriction slows down the entire gastrointestinal system. This system is one long tube. Muscle contractions starting with swallowing then lead to a long contraction through the entire tube. That’s how food moves through our bodies. Food restriction slows this down considerably and leads to what is called motility dysfunction, namely gastroparesis (slowed digestion in the stomach) and colonic inertia (food getting stuck in the colon). These illnesses lead to chronic fullness and bloating which makes it hard to eat regularly, even if someone wants to try to get well. There is treatment for both, but since the primary issue is the lack of food, nothing heals motility issues more than eating regularly again—a catch 22 for people with eating disorders.

The other most common gastrointestinal problem stems from laxative abuse. These medications stimulate the colon to expel stool and excess water and achieve temporary weight loss by dehydration but does not lead to sustained weight loss. However, chronic use leads to long term damage by weakening colon function to the point where, at its worst, normal bowel function is no longer possible. Instead, the damaged colon causes chronic, painful diarrhea. Often stopping laxative use will lead to significant recovery, even after long-standing use, but permanent damage is possible too.

Although these are the most common and severe gastrointestinal effects of eating disorders, there are other less common ones. Even more so, some simple eating disorder tricks cause significant distress. Bloating and gas are common and often result from overeating vegetables or fiber or chewing gum throughout the day. Various artificial sweeteners can act as a laxative when eaten to excess. Drinking too much coffee or soda frequently leads to bloating and nausea due to the caffeine and/or bubbles.

As recovery progresses, it’s important to pay attention to and manage all medical problems causes by an eating disorder but especially the gastrointestinal ones. Being sure a person’s body functions well helps recovery go forward and also enables that person to fully engage with life as they get better.