Written by John Immel, Asheville, NC

Introduction

You've recovered from an eating disorder, so why is your digestion still so fragile? Eating disorder recovery is a long path, and it doesn't always end once you've overcome the destructive eating patterns. Even if you've gone through the recovery process and have established a healthier relationship with food, the digestive tract may be left in a weakened state for years. In many cases, an eating disorder can leave a trail of chronic digestive problems in its wake.

The digestive tract undergoes a huge amount of stress during the course of an eating disorder and gut health can be detrimentally affected. It is an incredibly disheartening experience to feel ongoing digestive distress, despite all the time and effort dedicated to recovery. It can also trigger you back into unhealthy eating patterns and restrictive eating, particularly if there is a long list of foods you feel you "can't" eat.

However, the digestive tract has incredible capabilities to repair and recover. Ayurveda specializes in repairing digestion, and can offer essential support to restore gut health. The following article explains how an eating disorder affects gut health, and offers simple and practical steps to heal your digestion after an eating disorder.

How Eating Disorders Affect Gut Health

An eating disorder can have serious psychological and physiological repercussions, but the digestive tract is perhaps the worst affected system in the body. In anorexia, prolonged food restriction can cause digestive organs to lose their tone and atrophy. Muscular atrophy in the digestive tract is the degeneration and wasting of muscle mass and can cause serious loss of digestive function.

In bulimia, vomiting redirects digestive acids back up the GI tract, and that can create significant inflammation in the stomach and the esophagus. Ulcers are another digestive complication that can occur as a result of bulimia as harmful acids attack the lining of the digestive tract. Bulimia can also cause significant electrolyte imbalance due to the loss of fluids through purging, either by vomiting or the use of laxatives.

In both eating disorders, gas and bloating are common symptoms of the underlying digestive weaknesses or atrophy. Gas occurs due to fermentation of undigested food in the GI tract by bacteria. Thus, fermentation is a sign that bacteria levels have exploded in the gut, and are metabolizing the food and nutrients meant for your body. This can significantly impact nutrient absorption and means that even if the diet is healthy, the body may not be receiving all the nourishment it needs.

Restoring Gut Health Post Eating Disorder

Establish a Baseline with Simple Foods

The first course of action to heal the gut after an eating disorder is to find a baseline diet that strengthens your body while it reduces (not eliminates) excessive fermentation, gas and bloating. Absorption of nutrients improves significantly when you can digest your food easily. Generally, this baseline diet will contain very nourishing and hearty easy too digest, ojas building foods that won't challenge the digestive tract. This diet should leave you feeling delightly full and satisfied, and your body content. If a food makes you very gassy, try to find a nourishing, supportive alternative. Here is a list of typically difficult to digest foods, but remember everyone's body is different, so don't go strictly off the list.

Easy to digest foods include soups, stews, and well-cooked food. It includes pureed carrots, sweet peas, scrambled eggs, chicken, or sweet potatoes. Rice, fish, ghee, oatmeal, applesauce, and egg drop soup are all examples of easy to digest meals that will not strain the digestive tract. Herbs like hingvastak churna, black pepper, and ginger stimulate digestive strength (agni), eliminate ama, and improve absorption.

A nourishing, easy to digest diet is a general starting point to reduce digestive strain and support as the gut recovers. It's important to remember this baseline diet does not need to be perfect. You don't want to become too strict or obsessive as this can trigger old disordered eating habits and food choices. It is also important not to attempt recovering digestion through dietary changes until you are fully recovered from all disordered eating behaviors and have been for several years. If you feel you have few options that digest well, or that your diet has otherwise become too restrictive, please seek out a qualified practitioner.

Rebuild Fluids

Fluids tend to be depleted in the aftermath of both anorexia and bulimia. The first way to tell is to check if the tongue is dry. If so, it's likely the rest of the digestive tract is also dry, meaning it's lacking sufficient secretions. A dry digestive tract will not be able to digest, absorb, and assimilate nutrients. Rebuilding fluids is necessary to support strong digestion before each meal. Add a pinch of salt and a squeeze of lime juice to a glass of warm water and drink 30 minutes before a meal to rehydrate.

Small quantities of ingredients with salty and sour taste will further enhance hydration and digestive secretions. Ginger increases saliva production, and can also be chewed before each meal. Finely slice the ginger and add a squeeze of lime and pinch of salt to create an effective digestive stimulant. Another herb that can be used in certain cases to rebuilds fluids is licorice root, as it helps the body retain water.

Timing is Key

Timing and routine play a major role in restoring gut health after an eating disorder. Routine is one of the most important steps to strengthening your gut. Eating on a regular timetable helps your body get on a rhythm, secreting digestive juices at just the right time so your digestion is optimal. Eating on a schedule stabilizes blood sugar levels, which stabilizes mood and appetite. The opposite is true when a meal is skipped.

Skipping meals is a big no-no in eating disorder recovery, especially for bulimia. One of the patterns with bulimia is that the person binges, then feels guilty and skips a meal the next day. By skipping a meal, they can experience intense cravings, feel nervous, and binge again. This keeps them stuck in a cycle of binging and purging.

Having three solid meals a day is crucial to decrease the urge to binge. That means having breakfast, lunch and dinner every day at roughly the same time each day. Ayurveda recommends having a moderate breakfast at about 7am-8am, making lunch the largest meal of the day around 12pm-1pm, and ending with a lighter dinner at about 6pm-7pm, or at least two hours before bedtime.

This food structure will not only help your gut health, it can also take some of the decision making out of mealtimes which can be very stressful if you've dealt with an eating disorder and are accustomed to skipping meals. Having that structure can calm food anxiety as it makes food more predictable. This can be very helpful in the healing process of both anorexia and bulimia.

Rest & Recover

A gentle and restorative lifestyle is also very important to help the gut fully heal after an eating disorder. Create a daily routine outside of mealtimes, one that involves calming and nurturing activities like self-massage (abhyanga), paying special attention to the abdomen. A warm bath every night, a daily walk in the fresh air, and a relaxation practice in the afternoon, such as belly breathing, can provide the rest and structure that is essential to fully recovering the digestive tract, which is sensitive to stress.

Daily belly breathing increases the tone of digestive organs, promotes peristalsis, and stimulates blood flow to digestive organs. It can also help reduce stress and anxiety around mealtimes. Avoiding harsh diet and lifestyle practices, such as overworking and staying up late, is also important when restoring gut health after an eating disorder.

When Should I Cleanse?

Digestive weakness can cause an accumulation of toxins (ama) after an eating disorder. However, the best way to resolve this toxicity is by treating the cause, instead of going on a cleanse. We generally recommend against cleansing for a person with a past eating disorder. People with eating disorders, especially anorexia, are frequently attracted to the promises of purity and vitality that cleanses seem to promise. An excessive desire to cleanse can be a lingering symptom of past eating disorder habits. It can even trigger someone back into restrictive eating behavior.

A traditional Ayurvedic cleanse can be depleting. Most people who are recovering from an eating disorder have some form of deficiency, and a cleanse may worsen that. For these reasons, it is recommended to avoid seasonal cleansing, fasting, and panchakarma treatment until several years after a person is fully recovered and weight is normalized.

Conclusion

Eating disorders can significantly impair digestive function, and it can take years to fully recover from the long term effects. Luckily, Ayurveda's area of expertise is digestive health, and can offer support to those restoring gut health after an eating disorder.

By eliminating difficult to digest foods and implementing a diet of mostly well cooked, easy to digest foods, your digestive tract will have a chance to rest and recover. Dehydration and depleted electrolytes are common in both anorexia and bulimia, so sipping warm water throughout the day and adding a digestive stimulant before meals will improve digestive secretions. These 10 healthy habits to improve digestion will also help regain digestive strength (agni).

Restoring gut health is not all about diet. In fact, obsessing about what foods to eat and avoid may even trigger a person back into unhealthy eating patterns. Establish a gentle daily routine that supports you to get through the day feeling calm and stable. Regular meal times and early to bed are some of the best places to start. Healing digestion and gut health is an ongoing process. These steps will lay the foundations for restoring gut health after an eating disorder.

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