The 10th of October is World’s Mental Health Day, a perfect opportunity to bring up the complex subject of eating disorders. Many affected try various therapies or take psychotropics for long years, yet the disorder never truly leaves. It can be managed to some degree, often just to satisfy the close ones, but the person may continue to live in the shadow of its controlling demon forever. One of the possible reasons why eating disorders continue lies in an incomplete treatment, which can prevent one not only from improving but most importantly, WANTING to get better. What’s more, conventional dietary approach can even induce relapses. Below I will discuss some of the physiological (and often dismissed) aspects of eating disorders.
What are eating disorders?
They are defined as “mental disorders marked by an obsession with food or body shape” and include anorexia nervosa, bulimia nervosa, binge eating disorder, orthorexia, avoidant / restricting eating disorder, and other.
The important question is, what are the causes of eating disorders as mental? Not everyone who has suffered trauma or has low self esteem develops an eating disorder. Something else must come to the equation, and I believe it’s multiple physiological imbalances. Psychological aspects are often just a trigger and not the root cause.
Impaired digestion, gut toxicity, deficiencies and dysglycaemia
All of my clients with eating disorders have some sort of digestive issues that started before developing the disorder - it can be IBS (diarrhoea / constipation), indigestion, bloating, acid reflux, heartburn, no desire for meat. This is an indication that gut microbes are out of balance and food is not broken down properly, which can lead to uncontrollable sugar cravings, an increased production of toxins, ‘leaky gut’, and poor absorption of nutrients. As the eating disorder starts and continues, digestion is compromised further. Eating processed carbohydrates causes a blood sugar roller coaster which perpetuates binging, and damages gut microflora even more. It’s a vicious cycle.
The most common deficiencies include amino acids from protein breakdown, fat soluble vitamins A, D, E and K, B vitamins, magnesium and zinc, all key for mental health. Strong zinc deficiency can lead to picky eating, where the smell, taste and texture of certain foods may become very unappealing. Plenty become vegetarians or vegans but because plant foods are mostly carbohydrates, they are prone to more deficiencies and constantly swinging blood glucose levels.
Neurotransmitter imbalance, ‘leaky brain’
‘Leaky gut’ can eventually lead to a ‘leaky brain’. Undigested proteins and microbial toxins can escape through the ‘leaks’ and affect mood, behaviour and perception.
Moreover, as a result of improper digestion of proteins and gut degeneration, one can become low in serotonin and dopamine. Low serotonin can contribute to depressive episodes, and low dopamine can trigger feelings of worthlessness and inability to handle stress or process trauma. Addictive and obsessive behaviour acts on dopamine which can numb anxiety – a common pattern in eating disorders.
Proteins and fats are also required to build hormones which affect metabolism, sleep, emotions and stress response. Without the building blocks and with a concurrent frequent intake of processed carbohydrates, one can be anxious or put on weight quickly when not restricting food – a frequent cause why eating disorders keep relapsing.
Gluteomorphins and casomorphins (exorphins)
Inability to fully break down dairy protein ‘casein’ and grain protein ‘gluten’ can turn them into opiates which act like morphine. They are able to attach to serotonin and dopamine receptors, and induce obsessive behaviour. This is a possible reason why people with eating disorders often crave addictive foods like baked goods, starch, bananas and dairy. They are also called ‘exorphins’ (external endorphins, coming from the outside of the body) - substances which give a feeling of positive ‘hit’, inducing addictive behaviour.
What to do and what to be prepared for
Conventional dietary approach often focuses on sufficient calorific intake, portion control or generalised ‘healthy eating’ guidelines (what are these anyways?), and not necessarily on nutrient density or individual food triggers. Such a diet, often abundant in processed carbohydrates, can perpetuate feeding pathogenic microbes. This can result in further blood sugar swings, hormonal and neurotransmitter imbalances - all of which are the driving force behind eating disorders.
I believe that the treatment should be multidisciplinary, with psychotherapy and other complementary disciplines applied at the same time. Dietary changes should be implemented in stages, taking into consideration individual physiological symptoms, and not just the eating disorder itself. Saying that, in spite of perfect protocols, sticking to them is another thing because compliance is the main reason for therapy to fail. Plenty of my clients give up after stage one, often because of lack of support, depression and as a result - lack of motivation. Like with any chronic health condition, there are no magic supplements or shortcuts. Eating disorders take a long time to resolve and one should be aware that it will cost time and money.
Nutritional therapy should be truly restorative and therapeutic. The main aspects include:
Enhancing digestion, microbial diversity and absorption should play a central role in nutritional therapy. Protein and fat digestion (not just their intake!) is key to a successful outcome
Addressing the brain and gut connection, but also the brain and gut individually
Individual deficiencies should be addressed
Focusing on foods that are nutrient dense but relatively low in calories - the fear of putting on weight is a major roadblock to success
Understanding that patience is key. Dietary changes can initially cause digestive upsets and bring about other unwanted changes but these calm down over time. Persistence is the only way to break the vicious cycle
Sugar addiction, like any addiction, may require a specialist support on top of neurotransmitter balancing. L-tyrosine can be administered for addictive behaviour – consult with a professional
Gymnema Sylvestre can help to combat sugar cravings – consult with a professional
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