Tuesday, December 6, 2016

Tummy Turmoil

"Frozen Foods with String Beans," Irving Penn {c} Irving Penn Foundation
By Michel Harris, MS, RD, LDN, CDE
A significant part of the recovery process from an eating disorder involves adapting to a “normalized” eating pattern. However, many individuals experience one or more of the following gastrointestinal (GI) symptoms when they start the refeeding process: abdominal pain, nausea, bloating, constipation, diarrhea, and feeling uncomfortable full. Sometimes, healthy behavior changes make one feel worse in comparison to when he or she was practicing disordered behaviors like food restriction, binging, and purging.
            There are several reasons why these unwanted symptoms occur, and all relate to the physiological changes that occur with continuous disordered behaviors. The entire GI is composed of muscles that are stimulated to contract when one starts eating. Similar to the muscles in your arms and legs, if there is nothing to promote movement, these muscles become sluggish and weak. If one restricts his or her intake, either by eating very small amounts of food or going for long periods of time without eating, the muscles remain “under-exercised.” Laxative use for purging may cause diarrhea, constipation, and/or diarrhea. These symptoms tend to persist, even after discontinuing the use of a laxative.
            Unfortunately, these unwanted symptoms tend to encourage individuals to resume disordered behaviors because the mind-set of “why bother, when I am try so hard” sets in. However, these symptoms will resolve after a few weeks of consistent refeeding. In the meantime, the tips below can help reduce GI discomfort from refeeding.
·                 The refeeding process needs to occur gradually. One should never drastically increase his or her daily calorie intake because it could lead to serious medical complications (heart failure). If you are not in a medically supervised program, seek the help of a Registered and Licensed Dietitian (RDN) who can help with meal planning.
·                 An RDN will assist in creating a meal plan that includes foods from all groups. Avoid the inclination to fill up on high-fiber, low-calorie foods (fresh fruits and vegetables, whole wheat products); excessive amounts of fiber may contribute to diarrhea, abdominal discomfort, or constipation (if fluid intake is not adequate). Plus, you may feel too full to consume other nutrient-dense foods from the other groups.
·                 Eat smaller, more frequent meals to reduce the load on your GI system. This will gradually get an under-used GI system back into shape! The general recommendation is to eat something every three to four hours.
·                 Stay hydrated but don’t fill up on water. Fluid intake is important, but try not to drink too much with meals to avoid early satiety.
·                 Find options to ease your symptoms. There are over-the-counter medications to help with some of these GI symptoms, but you should consult with you medical doctor (MD) before purchasing any.
            No one needs to tell you that recovery is difficult! Keep in mind that your decision to seek treatment deserves much praise and continual encouragement. The discomfort felt at the beginning pays off in the future.
            On a final note, if after several weeks of following a recommended meal plan, persistent signs of abdominal pain, unintentional vomiting, bloating, diarrhea, constipation, nausea, and/or early nausea warrants a follow-up visit with your MD. He or she can assess your condition, and determine if a referral to a GI doctor is necessary.
Michel Harris a Registered and Licensed Dietitian and serves on the staff of The Awakening Center. She believes in the mindful approach to develop a peaceful relationship with food and exercise in the recovery process of eating disorders. To find out more or to set up an appointment with Michel, call 773.929.6262.

1 comment:

  1. Thanks so much for this informative blog article. So many of my clients develop very uncomfortable GI problems during recovery. I especially like the sentence "your decision to seek treatment deserves much praise and continual encouragement".