Last month, I wrote about what causes bloating and how to manage the discomfort that can arise as we recover from disordered eating patterns. In addition to the strategies outlined, there are several good resources to explore further, if you’re interested.
Three quick resources for additional info on gastrointestinal (GI) function in eating disorders include:
- An episode of Jessi Haggerty’s The BodyLove Project with Lauren Dear discussing eating disorders and GI health
- Marci Evan’s blog post on GI symptoms in clients with eating disorders
- Kate Scarlata’s article in Today’s Dietitian
It’s also helpful to keep in mind that there might be other reasons we’re experiencing challenging sensations in our bodies. A few of the common examples I see include:
- Perceiving any change in the stomach as uncomfortable fullness or bloating
- Mental or emotional associations with the sensations of hunger and fullness
- Anxiety symptoms can contribute to stomach pain
In the first example, changes that are very much appropriate and expected in the setting of eating a meal or snack are perceived as uncomfortable, unacceptable, or possibly indicative of a problem. It can be helpful to keep in mind that the role of the stomach as an organ in the body is to hold the food we eat as our body gets ready to digest and metabolize the meal or snack. This means it’s OK if it expands: a stomach that is full won’t feel completely empty because it isn’t meant to be completely empty. If we have lost some abdominal muscle through malnutrition or inadequate eating patterns, these changes can sometimes be pretty visible because the stomach wall is weakened and less effective at holding things in and up (and this can change as we rebuild and repair this tissue). All bodies will experience some changes in how the stomach feels as the meal progresses and we start to digest food.
Also, I frequently have conversations with clients where meaning is attached to sensations in the stomach. Sometimes, a feeling of hunger or emptiness can feel comforting, safe, or give us a sense that we’re “doing it right” (though “it” is usually the diet or the eating disorder, not nourishing ourselves). Fullness can feel vulnerable in that it doesn’t feel safe, it can feel like it’s a step on the path towards a binge, it’s not a sensation that has a lot of trust around, it’s a sensation that can bring up a lot of feelings of guilt.
Recognizing that there are emotions and associations attached to how our body feels as we eat can be helpful in unpacking the experience of a meal and any discomfort associated with it.
Finally, meals and snacks can be anxiety-provoking occasions. The tightness and constriction we feel as a symptom of anxiety can be located in our abdomen and contribute to feeling nausea or like we have an upset stomach. I’ve also had clients describe sensations of fullness impacting their ability to breathe deeply. The feeling is that the food in the stomach is displacing room the lungs and diaphragm need for a deep inhale; taking several deep breaths and relaxing the muscles can bring some improvement here.
A few suggestions that have been helpful to clients in the past for understanding and articulating the sensations we feel in relationship to a meal include asking ourselves:
- Where in my body am I experiencing this? Am I feeling something physical? Am I seeing something with my eyes? What sensory input is relevant here?
- How long does this last? Does the discomfort have a high point when it feels the worst? Do symptoms change over the course of 30 minutes, an hour, two hours? Do they not change or do I feel uncomfortable for long periods of time?
- Does anything shift or change is I utilize coping skills to manage anxiety or if I take deep breaths to relax the muscles?
Any information you can learn about your experience can be helpful as you and your team understand your body’s responses and identify possible solutions to managing symptoms or feeling better.