Ask An Expert Eating Disorders

Eating Disorders and Food Intolerance?

The topic of eating disorders and food intolerance seems to be coming up more and more with my clients, so I am sure your question will benefit many people!

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I have been recovered from an eating disorder for 9 years. A few years ago I stopped eating gluten and dairy. It was completely for health reasons and filtering it out of my diet was incredibly difficult, but it was done from and with a completely healthy mindset. However, it has slowly become increasingly more difficult to maintain that lifestyle. At some point, my mind labeled all gluten and dairy foods as “bad” since I’m “not supposed to eat them.” So the more time that goes by in which I can’t eat these foods, the more I want them. Sometimes I give in and then I can’t stop eating them and it’s followed up with my head tearing me apart for having these foods I shouldn’t eat. Listing to myself all the terrible physical repercussions of eating these foods is no longer effective and it seems impossible to separate food choices made for healthy reasons from the disordered thoughts that my mind remembers too well. I tried planning out meals in advance, but that wasn’t helpful either. How do I continue to cut out the foods that I’m intolerant to, yet maintain a healthy relationship with those foods?

Hi, K,

Thanks for reaching out and asking your question. This topic of eating disorders and digestive health seems to be coming up more and more with my clients, so I am sure your question will benefit a lot of other people!

There are a few different ways to go about this. I do recommend you talk about these options with a primary care physician or a dietitian so you can decide what is best for you.

1) Get tested: If you haven’t been already, it’s really important to be tested for sensitivities and intolerance.

They have genetic testing available, which can be important to see if you have the gene for gluten sensitivity. Also, you can get hydrogen breath testing for lactose intolerance. Having the evidence for the intolerance will assure that ED is not running the show. Remember, unlike a food allergy a food sensitivity is not life threatening and depends on the dose. Your dietitian can help you determine how much you can tolerate. Variety plays an important role so you are not having a large amount of any one food.

2) Eating mindfully: This idea of mindful eating is important when also struggling with intolerance and sensitivities.

Depending on where you are in recovery, mindful eating can support you in further building that healthy relationship with food, especially when dealing with food sensitivities. Part of mindful eating is asking yourself how you are going to feel after having a certain meal/snack. Before each meal and snack, practice asking yourself how you will feel emotionally and physically before/after eating the food item(s).

It is important to note many of these questions may be difficult to answer depending on where you are in your recovery journey. I encourage you to work through these with a dietitian.

Here are the questions: Will it fill you up to your desired fullness? How long will the item fill your for? Will you make it to your next meal/snack? How might your digestion feel after eating it? Is there another option that might make you feel better and will have a similar taste?

Again, I recommend working through this exercise with a dietitian who is experienced in mindful and intuitive eating a few times before trying it on your own.

3) Does your intolerance have a threshold? This tip is especially important for dairy products.

For some people, it is possible to eat dairy up to a certain point. I have some clients with lactose intolerance. They can have a small serving of ice cream, but anything more might set off their digestive symptoms. So, we talk about how to enjoy that small serving of ice cream.

It can be similar to other types of foods you are sensitive to, so definitely get a dietitian who specialises in food sensitivities and eating disorders on board.

4) Medications: Taking certain medications or over the counter supplements can relieve some GI upset, depending on the intolerance you have.

For many people, Lactaid pills work wonders for lactose intolerance. I have also had clients who have had success by taking digestive enzymes, probiotics or certain vitamin/mineral supplements to relieve digestive issues.

Of course, it’s important for you to discuss with a physician or a dietitian to assure you are taking the correct dosage.


Alex Raymond, RD, LD

Ask An Expert Column Disclaimer: Our “Ask an Expert” column is meant to serve as a place to ask a question anonymously and receive a public response from a certified health professional in the form of a Q&A-style article. Although our Experts are certified professionals in their area of expertise, their advice may not be suitable for your situation, and thus is not to be taken in place of that given by your personal healthcare team. Please always consult your own healthcare team before making any changes to your medication, activities, or recovery process. Always use your own good judgment, and consult a licensed mental or physical health practitioner for specific treatment. Do not use this column if you are in crisis. If you are in crisis, contact 911 (in North America), your local emergency number, or one of the Helplines listed in our resources section.

Alex Raymond, RD, LD, CEDRD

Alex Raymond is an eating disorder dietitian in private practice in College Park and Columbia, MD. Alex specializes in treating individuals struggling with anorexia, bulimia, and binge eating disorder. She practices from an intuitive eating model and enjoys working with individuals to improve body image. She is a passionate Health at Every Size © advocate and anti-diet dietitian. Alex provides eating disorder nutrition counselling in College Park and Columbia, MD. Alex's College Park office is within walking distance from the University of Maryland.

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