Physical Barriers to Eating Disorder Recovery: Part 1

Recovering from an eating disorder is incredibly difficult. It takes a team of professionals: at the very least, an MD, a therapist, and a certified nutritionist or registered dietitian. It usually takes years to achieve full recovery, often with many relapses along the way.

Researchers are still working to pinpoint exactly what the key is to recovery. While we haven’t yet found a magic pill to cure eating disorders, there have been many advances made in the field of eating disorder recovery. In this series, I’ll share with you three things that helped in my own recovery, and that have proved useful to many clients in my own practice. Fair warning: much science-y stuff to follow.

First up: Digestion

Anyone who’s been through the process of recovery will tell you: it’s uncomfortable. It’s emotionally excruciating, and can also be uncomfortable physically. For a body that isn’t used to eating food on a regular basis, or one that has engaged in purging of any kind, completing digestion on even a small amount of food can lead to pain, bloating, and *ahem* digestive distress.

When I was in the hospital, my stomach would bloat to the point where I thought my skin would rip, and my “innie” bellybutton was threatening to become an “outie”. They gave me all the antacids in the world to chew, but nothing helped.

When I began studying holistic nutrition, I found out that not all digestive issues are caused by high stomach acid: sometimes it’s LOW stomach acid that’s to blame.

How does it work?

When the stomach isn’t used to producing much stomach acid, due to low food intake, or is used to having its acid contents purged, the parietal cells may not make enough acid to digest normal amounts of food. This leads to food sitting in the stomach for longer than normal, making a person feel overfull for extended periods of time. When the food sits without digesting, it begins to ferment, causing a release of gas that leads to bloating, burping, and sometimes reflux.

Why is this a problem?

Not only do the parietal cells make stomach acid, they also are responsible for the secretion of pepsin (a protein-digesting enzyme), and intrinsic factor, which is necessary for adequate absorption of Vitamin B12.

Not having enough B12 in your system can result in nerve problems, digestive problems, fatigue, and mental problems like depression and anxiety.

Depression and anxiety often walk hand-in-hand with eating disorders. It’s hard to say which comes first, but each contributes to the other. Depression and anxiety can be huge triggers for eating disorder symptoms and, as it turns out, being malnourished from eating disorder symptoms can contribute to depression and anxiety.

The enzyme secreted by the parietal cells, pepsin, is responsible for the digestion of protein, breaking it down into its smallest particle, the amino acid.  Amino acids are important in so many functions of the body. They’re not just there for muscle building: you need protein to create enzymes, aid in the function of every organ in your body, and for the creation of neurotransmitters.

Serotonin, a neurotransmitter affecting mood, sleep, and appetite, has a key amino acid component: tryptophan. If our digestion isn’t working properly, we can’t break our food down into amino acids, and we don’t get enough tryptophan to build serotonin. The depression-anxiety-eating disorder cycle continues.

So what can you do?

While any major changes to your routine should be discussed with a practitioner, there are a few things you can do at home to help support your digestion:

  1. Stay hydrated. Stomach acid’s fancy name is hydrochloric acid. The “hydro” part means water. Water is involved in every digestive process, right down to the cellular level. Drinking too much with meals can dilute your stomach acid, but if you stay hydrated throughout the day, you’ll be doing your digestion a huge favor.
  2. Don’t fear the salt! The other part of hydrochloric is the chloride part, which is half of the fancy name for salt: sodium chloride. A pinch of sea salt with your meals is a great way to support your digestion.
  3. Tart it up. Lemon water is great to stimulate your digestive juices, as is apple cider vinegar. You can use it in salad dressings, etc, or even drink a capful prior to meals to get things going.
  4. Include probiotic-rich foods in your diet. While probiotics help further down the line, they are an important part of digestion. Some great studies are being done right now on the importance of probiotics in eating disorder recovery. Foods like yogurt and kefir, kombucha, sauerkraut, and even brined pickles can help you there.
  5. Take some deep breaths. As we’ll discuss in part 2 of the series, stress levels can greatly impact your digestion. Taking a few deep breaths before meals to calm yourself can really help.

If you’ve tried these things and your digestion still isn’t improving, seek the help of a practitioner (like me!) who can help you safely navigate some more in-depth digestive healing methods.

While digestive healing may not be the entire answer to the depression-anxiety-eating disorder cycle, it can contribute to it. Do the emotional work in therapy, take medication if you need it, and work on healing your body. Eating disorders don’t have to be forever. Recovery is possible. (You’re worth it)


4 thoughts on “Physical Barriers to Eating Disorder Recovery: Part 1

  1. Lorrae Jones

    Hi Kelly, I was recommended a digestive enzyme as have pancreatic insufficiency. It took me ages to find one that agrees with me and wasn’t too strong. Can enzymes that contain HCI be a good and helpful thing or can they be too strong and irritate the gut if I have severe malnutrition and long term eating disorder?

    1. Kelly Boaz Post author

      Hi Lorrae,
      Sorry for the delay in getting back to you! For some people, yes, HCl can be far too strong. If that’s the case, looking for a vegetarian digestive enzyme supplement is the best option. For some people, supplementing with HCl can really help digestive difficulties, but for others, it’s just not the right option. Hopefully whoever recommended the supplement to you can help you find an appropriate option for you!
      Let me know if you have any other questions 🙂


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