Jessica Cadbury | Is dieting linked to your IBS?

Jessica Cadbury is a Health at Every Size®(HAES) nutritional therapist and is also a Certified Intuitive Eating Counsellor. Cheltonians, we are really very lucky to have an expert of this area of nutritional therapy in our wonderful town because Jess is one of the UK’s only 4 HAES practitioners. 4!


Jess has bravely written about her own disordered eating and IBS experiences, covering important points that are seldom discussed. So without further ado, over to you, Jess, to teach us more.



Irritable Bowel Syndrome (IBS): a particularly pesky issue linked to dieting.


IBS is an umbrella term for otherwise un-diagnosable symptoms like stomach cramps, diarrhoea, constipation, bloating and excessive gas. No one knows for sure what causes IBS, but it has been linked to things like stress, family history, food passing through your gut too quickly or slowly, an oversensitive gut and disordered eating. There is also no known cure, although people will often be advised to manage it through medication and/or dietary changes.


If you suffer with IBS, you know that it can be an inconvenient, sometimes embarrassing and life-limiting condition. Precious time and energy can be spent worrying about where the nearest toilet is, whether your stomach is going to make weird noises at inappropriate moments, if you will get through the day without feeling painfully bloated and avoiding socialising.


My story


To help illustrate how dieting may be linked to your IBS, I’m going to share with you a bit about my own experience.


At 21 (I am now 32) I was diagnosed with IBS, and told that there wasn’t much I could do about it: "Just avoid dried fruit and other high fibre foods".

It should be noted that at this time in my life I was also experiencing very disordered eating (including bingeing and purging), poor body image, chronic anxiety and bouts of depression. I didn't think to tell my doctor about these issues because I didn't think they were linked to my IBS. Instead (although coeliac disease had been ruled out) I decided that gluten was the culprit and cut it out of my diet.


Fast-forward to my mid/late-twenties and I was still militantly gluten free, my IBS had worsened and I felt like I was barely managing my symptoms through an increasingly restrictive diet. I was obsessed with what I could and couldn’t eat, had spent hours researching and was desperate to find the answers. It was exhausting.


From the outside, no one would have ever known that I had IBS, let alone that I was giving so much time and energy to worrying about my nutrition on a daily basis. In fact, far from anyone recognising that I may have had an issue with food, people would praise my food choices and I was becoming known as a bit of a “healthy” eating expert amongst my friends.


I was also constantly trying to shrink my body by restricting my energy intake and tracking my diet on an app. I now know that the calories I was allowing myself matched the suggested calorie intake for a child of 2-3 years of age.


Looking back, it’s scary to think that everything I was doing was, and still is, totally normalised by diet culture (commonly disguised as “health & wellness”), and the praise and interest from friends about my “healthy lifestyle” continued.

At age 28, I developed adult acne and noticed that my periods were becoming more and more irregular. I went to get myself checked out and was misdiagnosed with PCOS (Polycystic Ovarian Syndrome).


Unfortunately, this diagnosis sent me further down my “healthy lifestyle” rabbit hole, ensuring I ate even “cleaner” and followed an intense exercise routine. I now recognise that I was probably suffering from Hypothalamic Amenorrhea (HA); a condition in which menstruation stops because of high stress levels, undereating and over-exercising. The primary treatment for HA is reducing and managing stress, eating more and reducing (or cutting out completely) exercise. Frustratingly, I did the opposite.


Thankfully, things began to change for the better whilst studying for my nutrition MSc when I discovered Intuitive Eating and HAES.


It has been a long, non-linear and sometimes painful journey, but I have made peace with food. This means unconditional permission to eat, no tracking or counting calories, no guilt or shame about my food choices and eating a wide variety of yummy foods, from pepperoni pizza to prawn and vegetable stir-fry, chocolate chip cookies to carrots and hummus. And guess what? My periods are regular, my stress levels and mood are much more manageable and stable and my IBS symptoms have vastly improved. I still have the occasional flare up, but this is almost always related to stress.


Your IBS


So, how is your relationship with food linked to your IBS?


Evidence shows that IBS is incredibly common in those who have disordered-eating (aka dieting) and eating disorders.

One major factor at play here is the stress that your body is put under with dieting and disordered eating, and as stress literally impairs digestive function, it’s not too difficult to see the connection. Bottom line: dieting is not healthy.


How do you know if you have a disordered relationship with food? Behaviours like calorie counting, macro tracking, cutting out foods / entire food groups without medically needing to do so, compensatory under eating or exercise, “cheat days,” portion control, skipping meals, meal replacement shakes or bars, body-checking, guilt about eating certain foods and regularly weighing yourself are all considered disordered (although most of these are very much normalised in diet culture).

As I mentioned before, there are no definitive causes for IBS, but if you are a fellow sufferer and you’ve ruled out any underlying health conditions, you may want to consider what role your relationship with food could be playing.



Jess has kindly listed some resources below. She also offers one to one Intuitive Eating sessions at either her Cheltenham clinic or online. Visit her website for more info.






Books

Anti-Diet Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating by Christy Harrison.


Just Eat It: How Intuitive Eating Can Help You Get Your Shit Together Around Food by Laura Thomas


Intuitive Eating, 4th Edition: An Anti-Diet Revolutionary Approach by Elyse Resch and Evelyn Tribole


Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight by Lindo Bacon and Lucy Aphramor


Websites

https://www.nationaleatingdisorders.org/size-diversity-health-every-size

https://healthateverysize.org.uk/

https://www.intuitiveeating.org/

https://www.thecenterformindfuleating.org/

https://www.healthnotdiets.com/

https://www.unpackingweightscience.com/


References used for this article

Sizediversityandhealth.org. (2020). ASDAH: HAES® Principles. [online] Available at: https://www.sizediversityandhealth.org/content.asp?id=152


Intuitive Eating. (2020). 10 Principles of Intuitive Eating | Intuitive Eating. [online] Available at: https://www.intuitiveeating.org/10-principles-of-intuitive-eating/


Bacon, L. and Aphramor, L. (2011). Weight Science: Evaluating the Evidence for a Paradigm Shift. Nutrition Journal, 10(1).


Boyd, C., Abraham, S. and Kellow, J. (2005). Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders. Scandinavian Journal of Gastroenterology, 40(8), pp.929-935.


NHS.uk. (2020). Irritable bowel syndrome (IBS). [online] Available at: https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/


NHS.uk. (2020). Coeliac disease. [online] Available at: https://www.nhs.uk/conditions/coeliac-disease/


www.heart.org. (2020). Dietary Recommendations for Healthy Children. [online] Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/dietary-recommendations-for-healthy-children


nhs.uk. (2020). Polycystic ovary syndrome. [online] Available at: https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/


Verywell Mind. (2020). So You’ve Lost Your Period—How Can You Get it Back?. [online] Available at: https://www.verywellmind.com/hypothalamic-amenorrhea-4687508#what-is-hypothalamic-amenorrhea


Boyd, C., Abraham, S. and Kellow, J. (2005). Psychological features are important predictors of functional gastrointestinal disorders in patients with eating disorders. Scandinavian Journal of Gastroenterology, 40(8), pp.929-935.


Harer, K. (2019). Irritable Bowel Syndrome, Disordered Eating, and Eating Disorders – Gastroenterology & Hepatology. [online] Gastroenterologyandhepatology.net. Available at: https://www.gastroenterologyandhepatology.net/archives/may-2019/irritable-bowel-syndrome-disordered-eating-and-eating-disorders/


Tomiyama, A., Mann, T., Vinas, D., Hunger, J., DeJager, J. and Taylor, S. (2010). Low Calorie Dieting Increases Cortisol. Psychosomatic Medicine, 72(4), pp.357-364.


Qin, H. (2014). Impact of psychological stress on irritable bowel syndrome. World Journal of Gastroenterology, 20(39), p.14126.