I’m just gonna say it: Constipation.
As someone who grew up listening to Avril Lavigne, I learned at around thirteen years of age that the correct way to sing the chorus for ‘Complicated’ is, in fact, “Why’d you have to go and make things so constipated?”
Yes, eating disorder, why??
Because of my irregular eating habits, I was severely constipated for years. As you can imagine, this was incredibly uncomfortable. I had no idea that it was related to under-nutrition — in fact, I was convinced that I needed to eat even more kale and drink even more black coffee to get things moving (for the record, this didn’t work). Not to get into too much detail, but sometimes I went over a month without a poop.
…Yeah, not good.
I was drinking dandelion tea every day and trying all kinds of laxatives — nope.
The other gastrointestinal symptom that bothered me was getting full very quickly. I remember going to lunch once and being full from exactly 1 piece of sushi. Even when I tried to re-feed myself by setting calorie minimums for the day, I would get nauseous and be unable to take in more food. This inadvertantly fueled my eating behaviors, and helped me “prove” to myself (and concerned others) that I simply wasn’t hungry. I’d snap defensively, “I don’t want to eat because I’m honoring my natural hunger cues!” True, but my hunger cues were no where near natural or healthy – they had gone into hiding, defeated by years of being ignored. (This doesn’t mean I was never hungry: sometimes I woke up in the middle of the night with unbearable & piercing hunger that I can only describe as ‘primal’ – and I don’t mean paleo).
So, what the heck was going on body-wise? It turns out that a condition called gastroparesis that can help to explain things. Gastroparesis literally means “paralysis of the stomach”. It is also known as “delayed stomach emptying”. It’s a major traffic jam. Gastroparesis is practically universal whenever there is severe caloric restriction (source). As your body tries its best to conserve energy, your digestive system starts slowing down. Moreover, since food intake is inadequate, your wonderfully smart body holds on to whatever food there is for longer, so that more nutrients can be absorbed.
The fallout: unpleasant GI symptoms.
Gastroparesis can make recovery very difficult. For someone who has an eating disorder, the idea of eating more is already terrifying, and having GI discomfort can be a big roadblock. This was the case for me. Shortly after I started working with a Registered Dietitian (RD) who specialized in eating disorder recovery, I started feeling sicker. I was nauseous and bloated and all kinds of miserable and absolutely convinced that I needed to STOP recovery and go back to my restrictive diet, which involved staying under the daily nutritional requirements of a toddler. I’m grateful that I had the professional support and medical monitoring from a specialized PCP to keep going in a way that was safe for my body.
The good news? Full nutritional rehabilitation usually results in 100% restoration of normal bowel moments. My husband and I often compete for the bathroom in the morning. When I struggle in recovery and start to miss my smaller body, I think about how my GI system lets me know (in no uncertain terms!) that it is thriving and happy now that it is being fed appropriately.
I’m not even touching on the very trendy ~gut-brain connection~ here because I don’t have anything definitive to share, but it wouldn’t shock me at all if it turned out that major disturbances in the gut and disturbances in mental and emotional health were intertwined. One more reason to prioritize (or be grateful for) a happy gut 🙂