Have you been curious about the topic of gut health? Simply put, the gastrointestinal (GI) tract is a major component of our body’s digestive system. It transports food from your mouth through your intestines, absorbs nutrients, stores energy, and gets rid of waste. Without it, well, we wouldn’t survive. In recent years, research shows that the GI system (and something called the microbiome) play a role in digestion far larger than previously known. We’ll dive deeper into both the GI system and the microbiome below, don’t fret. However, we are also learning more about how eating disorders and our overall relationship with food can impact our gut health.
Hold on tight - we’re diving into all things GI tract/gut/microbiome as well as the specific role it plays with eating disorders. But first, a little background.
what exactly is the "gut"?
The digestive system consists of the gastrointestinal tract alongside three organs - the liver, pancreas, and gallbladder. Think of the GI tract as the passage that food takes once it enters your body, from mouth to anus. Here’s the exact order from start to finish: mouth → esophagus → stomach → small intestine → large intestine → rectum → anus. As for the organs, they are responsible for creating, storing, and releasing enzymes and digestive juices. These juices break down macronutrients (protein, fats, carbs) and micronutrients (vitamins, minerals) once they enter the stomach and small intestine. The gut, as it’s often called, is actually just another term for the entire digestive system.
so why is gut health important?
The term “gut health” refers to the health of the entire digestive system. Everything we eat passes through the gut. Along the way, nutrients are absorbed and carried to different parts of the body for use. Additionally, unwanted materials are excreted through waste. The gut also contains good bacteria that strengthen the immune system (more on that later).
What does a healthy gut feel like, you ask? Good digestion and absorption of nutrients along with little to no GI distress signs or disease is a good place to start. Issues related to digestion such as abdominal pain, bloating, diarrhea, constipation, heartburn, nausea, or vomiting are common signs of a gut that might need some help. New science, as we will discuss further, has linked gut health to the health of almost every other organ in the body. This even plays a role in mental and emotional health. You may now be seeing why gut health is such a hot topic these days.
Now, to the buzzword of current science: the microbiome
The human microbiome consists of about 100 trillion microbes (microorganisms or microbes known as bacteria, viruses, fungi). While these microorganisms can be found everywhere in the body, the majority live in the gut. So, the gut microbiome refers to the hundreds of microorganisms (bacteria, mostly) that live in the GI tract. While bacteria may sound like a bad word when talking about the body, many types of bacteria that live in the GI tract are healthy and extremely beneficial to us. Each person has a unique microbiome. Studies show that the more diverse those microbes are, the healthier you *might* be. We say might because the study of gut health is an extremely new field - more information is discovered constantly.
Even so, we do know that there is a delicate balance between good and bad bacteria in the gut - some fight inflammation and some promote it. This balance is ever important in fending off both acute and chronic disease. Studies show that if the balance becomes, well, unbalanced, that bad bacteria can take over and cause inflammation across the entire body. Newer research focuses on the link between gut health and mental/neurological health, from anxiety and depression to schizophrenia. We’ll discuss this more below, especially as it relates to eating disorders. The GI tract is interconnected with all our body systems - in particular our immune system and our brain - and optimizing its health is vital to maintaining health as a whole.
what messes with the gut?
There are a few things that can mess with your gut: delivering a baby, environment (aka where you grew up, living in an urban or rural environment), emotional stress (think: stress around food and body), and a wide variety of medications from antacids to painkillers and most importantly, antibiotics. Inconsistent or inadequate food intake throughout the day can also mess with your GI tract. This may cause many unwanted symptoms (ie: nausea, bloating, constipation, early fullness). In eating disorder recovery, these GI symptoms are widely reported and can be a barrier to increasing intake. Which makes sense - it’s a lot harder to eat when you don’t feel good. Let’s dive a little deeper into how eating disorders can impact your gut.
the gut with an eating disorder
The gut actually has a direct pathway to our brains, via what scientists call the “gut-brain axis.” The brain communicates with the gut and vice-versa via the central and enteric nervous system. These two systems regulate mood, behavior, metabolism, and appetite control.
While intensive studies have not yet been performed, it is theorized that those struggling with disorders have lower levels of serotonin (the “happy” neurotransmitter) than others - and 80% of that serotonin can be found in the gut. When the gut does not receive enough food, it can’t produce enough serotonin. This leads to increased levels of anxiety, depression, and obsessive behavior. A starved gut may also allow competitive, “bad” bacteria to take control of the place, causing stomach discomfort and increased risk of infection.
As you can see, the eating disorder itself can affect the gut directly. This creates stress within the microbiome that impacts hunger, desire, metabolism and satiety when it comes to eating. This stress and subsequent imbalance is what then leads to an increase in anxiety and depression.
The gut-brain connection with eating disorders represents a complicated relationship. Both affect the other, and it’s not always clear which came first. Existing microbiome imbalances can lead to increased anxiety, and eating disorders can lead back to those imbalances. Either way, it’s clear that when the gut is unhappy, the brain is likely also unhappy. It is essential to consider both functions and their relationship when working in your eating disorder recovery.
ok so how do you keep the gut healthy?
Eating a wide variety of foods, consistently throughout the day can help the gut bacteria have a consistent source of nutrition so they can adequately do their job. While increasing intake and variety is an understandable struggle in eating disorder recovery, the more consistent you are with intake the easier it soon becomes.
examine your stress levels around food
Stress or anxiety at meal times can cause GI upset and lead to a cycle of disrupting gut bacteria. If you feel that this is happening with you in your recovery process, try working with your team on ways to manage your stress before and after meal times. This could look like different skills or medications - whatever works for you. Remember, your team is here to help support you and provide guidance along the way.
trial increasing pre and probiotics in your diet
As a high level overview, probiotics are beneficial microorganisms that can be found in food or supplements. Prebiotics are a type of carbohydrate (mostly fiber) that feed probiotics. Together, they help support the good bacteria and other microorganisms in the gut, which in turn helps maintain good digestive health. Both pre and probiotics are found to aid a number of GI symptoms, as they help to re-balance the bacteria, repopulating the gut with more “good” bacteria. Current research is focusing on how pre and probiotics can actually make weight restoration and re-nourishment easier in ED patients. Be sure to consult with your RD to discuss what brand and mixture is best for your particular issues.
Pre and probiotics in food:
You can eat your ‘biotics too! As mentioned above, prebiotics are a naturally occurring fiber found in certain types of food that help to feed the gut bacteria. Meanwhile, probiotics are the actual bacteria that’s helpful for cultivating a healthy gut! Focus on adding a few servings of any of these foods to your meals or snacks to reap the benefits:
- Certain cheese: Cheddar, cottage cheese, mozzarella, gouda
While both pre and probiotics are naturally found in foods they are in smaller amounts than are found in supplements, so additional supplementation may be warranted. Make sure to check with your doctor or outpatient team about specific supplements that would work best for you.
All to say, the link between your overall gut health and eating disorders can be complicated and is very specific to your own recovery process. However, it is important to remember that no matter what your body (and gut) need food to function optimally.
You deserve to eat and we want to know that we will be cheering you on the whole time. If you are looking for more support around your eating disorder recovery contact our office or join the Eating Disorder PATH for 24/7 ED Support.