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Constipation and eating disorders, how to help

Constipation and eating disorders.

Constipation in eating disorders and disordered eating recovery is a tricky situation to navigate and one that I do not think is talked about often enough. So in this blog we are going to dive in that uncomfortable topic. Firstly, what is constipation?

What is Constipation?

Text saying constipation and eating disordres on a peach background

Constipation happens when bowel movements become less frequent and more difficult to pass, often causing discomfort and bloating. It is classes as passing a bowel movement less than 3 times a week.

Several factors can influence gut function and lead to constipation, including inadequate fibre intake, dehydration, stress, and irregular eating patterns—all of which can affect the speed at which food moves through the digestive tract. The slower the transit time, the more water is absorbed from the stool, making it harder to pass.

There are also plenty of other gut symptoms that can happen in eating disorder recovery and you can read more about these in some of our other blogs.

Constipation and Eating Disorders, what are some causes? 

Constipation can be a common issue in all kinds of eating disorders. There can be many causes and it can make the process of recovery more frustrating to navigate. Let’s think through some common causes for constipation that are not related to eating disorders specifically first. Can you identify with any of these?

Common Reasons for Constipation

Constipation can be triggered by several factors, including:

  • Lack of Fibre: Fibre adds bulk to the stool, helping it move more easily through the intestines. Diets low in fibre are a common cause of constipation.
  • Too much fibre: Eating a diet too high in fibre and specifically the brown, wholemeal, insoluble forms of fibre rich foods can lead to constipation too. Our bodies need the right balance of fibre which is where working with a specialist dietitian can help. 
  • Dehydration: Water helps soften stools. Without enough hydration, stools become dry and difficult to pass.
  • Sedentary Lifestyle: Physical movement helps stimulate the intestines. A lack of exercise can contribute to sluggish digestion. This doesn’t mean you need intensive exercise, there are stretches and gentle moves that can help your digestive system.
  • Stress and Anxiety: These can disrupt normal digestion and lead to constipation, as stress hormones slow gut motility. 

Constipation and Eating Disorders – Anorexia Nervosa/restriction:

In restrictive eating disorders, such as anorexia nervosa, constipation is particularly common due to a combination of factors. Not eating enough causes the digestive system to slow down. The gastrointestinal system is made up of muscle and so there can be a loss of muscle mass and strength if you are restricting your intake. This can mean your food takes longer to digest as the body slows down its functions to conserve energy. It’s like you are running on a 50% rechargeable battery that is losing more charge each time you digest and not getting recharged. 

Combine the above facts with the fact that often people with anorexia can be having higher fibre versions of foods. Plus the longer food stays in the digestive tract, the more water is absorbed from it, leading to harder stools. I’m hoping you can see how constipation can occur.

Constipation and Eating Disorders – Bulimia and Binge Eating Disorder:

Constipation is not limited to those suffering from anorexia. If you have bulimia or binge eating disorder then constipation can be common too. This can occur due to the erratic patterns of eating and restriction that occurs too. You may feel constipated after a binge episode as the body works to digest. This is an uncomfortable feeling and a time for lots of self compassion and comforting items. Read on for more things that may help.

On top of this, laxative misuse, often seen in some eating disorders, can disrupt normal intestinal functioning. Over time, this misuse weakens the muscles of the bowel, creating dependency and paradoxically contributing to chronic constipation.

Constipation and Eating Disorder Recovery

Constipation can remain a challenge during the recovery process from an eating disorder. As the body heals and normalises digestive function, it may take time for bowel movements to regulate. It’s essential to be patient with your body during this period and understand that recovery isn’t linear.

Because the digestive system has been compromised, it needs time to adapt to changes in food intake and improved nourishment. With proper care, hydration, and a gradual increase in dietary fibre, bowel movements should improve over time.

How to Manage Constipation and Eating Disorder Recovery

Managing constipation involves addressing both immediate symptoms and long-term digestive health. Some key steps include:

  1. Modify Fibre Intake Gradually: Fibre is crucial for good gut motility, but increasing it too quickly can lead to bloating and discomfort. Aim to incorporate more fibre-rich foods such as fruits, vegetables, whole grains, and legumes into your diet at a steady pace. It may be that you already have a high fibre diet and it is actually too high so you could also consider reducing this slightly. Working with a dietitian like myself can help you with this. 
  2. Stay Hydrated: Drinking enough water (but not too much) and other fluids is essential for softening stools and supporting healthy digestion. Aim to drink throughout the day, particularly if you’re increasing your fibre intake. The average is 8 glasses of water/drinks a day.
  3. Exercise and Movement: Regular physical activity helps stimulate the muscles in your digestive tract and keeps things moving. This doesn’t have to be high intensity which can be detrimental in some stages of recovery. Opt for low intensity activities like walking, pilates and  yoga which can really help.
  4. Avoid Laxative Misuse: Although laxatives may seem like a quick fix, they can worsen constipation in the long run by weakening your bowel muscles. Instead, focus on long-term dietary changes.

Good Foods for helping with Constipation in eating disorder recovery

To promote healthy digestion and manage constipation, here are some foods that can help:

  • Fruits: Apples, pears, and berries are high in fibre and water, making them great choices for constipation relief.
  • Vegetables: Leafy greens like spinach, broccoli, and carrots are fibre-rich and support gut health.
  • Whole Grains: Oats, brown rice, and whole wheat bread provide insoluble fibre, which adds bulk to stool and speeds up transit time. Take care not to overdo these and to increase them gradually in your diet. 
  • Legumes: Beans, lentils, and chickpeas are excellent sources of  soluble fibre.
  • Water: Staying hydrated is critical for preventing constipation. Be sure to drink enough water along with other hydrating beverages throughout the day.

Conclusion on constipation in eating disorder recovery

Constipation in eating disorder recovery can be a frustrating symptom. By understanding the factors that contribute to constipation and taking steps to support your digestive system through fibre, hydration, and a balanced approach, you can manage and alleviate symptoms over time.

Working with someone from the Dietitian UK team will help you have a personalised approach to your eating and we can work together on your digestive symptoms alongside your eating disorder recovery.

FAQ:

Can undereating cause constipation?

Yes it can. Eating too little can cause the digestive system to slow down. This means food takes longer to pass through the intestines and that food waste can build up in the system. 

Can constipation cause an eating disorder?

Whilst I do not have stats to share on this, it is something I come across. If your body feels so uncomfortable due to constipation it can lead to restricting your intake. Whilst in the short term this may alleviate the pain, it is not going to help long term. 

Are laxatives a good option for constipation? 

Laxatives may help some people short term but they are not a good long term solution. We want to work on the reasons behind the constipation and see if dietary strategies can help. If you are using laxatives then this needs to be looked after by your doctor rather then relying on over the counter preparations. 

Should I keep eating if I have constipation?

Yes you definitely need to keep eating. Working with a specialist dietitian can help you make alterations to your diet to help with the constipation.

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