In the world of dietary preferences and health trends, the line between food sensitivities and eating disorders can often blur. What begins as a conscientious effort to avoid digestive discomfort related to food can sometimes evolve into a more complex relationship with food—one that mirrors the patterns of disordered eating.
This phenomenon raises crucial questions about how you perceive and manage your dietary needs. Are you truly sensitive to certain foods, or are you using this as a guise to restrict your intake? Moreover, the overlap between digestive discomfort associated with eating disorders and the symptoms of food sensitivities adds another layer of complexity to this discussion. Exploring these intertwined issues is essential for fostering a balanced approach to both physical health and psychological well-being.
What are food sensitivities?
Food sensitivities trigger an immune response in your body that can cause symptoms of digestive problems, headaches, joint pain, muscle pain, skin issues, and/or fatigue.
The tricky thing with food sensitivities is that they are dose dependent. This means that you may experience no symptoms with a small portion of the food. Say a few carrots in a soup. Or even a full portion of the food like ½ cup of cooked broccoli. But at a certain dose, let’s say broccoli three days in a row for dinner, you may experience symptoms.
Another aspect unique to food sensitivities is that they can have a delayed response. They can occur 45 minutes to 3 days after you have the food and that before you develop symptoms. This can make the process of identifying and treating food sensitivities very challenging.
Food sensitivities are not food intolerances or food allergies
Food intolerances are when your body is not able to break down the food. With lactose intolerance, it’s not the milk that’s an issue but your ability to digest milk sugar. With this particular intolerance an option is to take a lactase enzyme pill, which supports your body in breaking down milk sugar.
Food allergies create a different and much more dangerous reaction in the body and can be life threatening. Reactions are commonly immediate, occurring within 1 hour of eating the food. They can involve anaphylaxis, immediate GI symptoms, or hives on the skin.
Due to the type of reaction and rapid onset of symptoms, food allergies are often easily diagnosed by an allergy specialist. You can also be tested for food allergies by blood test and/or skin prick test. Reactions can occur with even the smallest dose so total avoidance of the food is necessary.
It is important to note that food allergies can be outgrown in some cases and can be reevaluated by an allergist.
What about celiac disease? Is that a food sensitivity?
Celiac disease is another food related response important to add to this list. Celiac disease is an autoimmune disease where ingesting gluten causes physical damage to the intestines that can be permanent if not properly diagnosed and treated. Treatment for celiac involves completely removing wheat, rye and barley from the diet.
Food sensitivities and dietary restriction
Someone with a food sensitivity may practice a level of dietary restriction. Avoiding trigger foods can decrease uncomfortable symptoms like digestive discomfort, brain fog, fatigue, joint pain and headaches and allow the body to heal with time.
An important goal of treatment for food sensitivities is to properly identify what foods you are sensitive to and ascertain what frequency and dose you can tolerate without producing symptoms. Ideally someone with food sensitivities will still be able to eat and enjoy a wide variety of foods.
Distinguishing food sensitivities from eating disorders
It can be tricky to separate food sensitivities and eating disorders since they both involve dietary restriction. But there are important differences to be aware of.
One important distinction is the motivation behind the restricted eating. Motivation to cut foods out with a food sensitivity is to decrease symptoms and heal the body while motivation to cut foods out with an eating disorder is related to fear of weight gain, low-self worth, or even self-punishment.
With an eating disorder, someone might restrict certain foods, or sometimes even whole foods groups, for fear that it will “make them fat.” A telltale sign that restricted eating could be disordered is making sudden, drastic changes to your eating habits– like becoming vegetarian or vegan overnight despite never showing interest in vegetarian eating in the past.
Likewise, someone with an eating disorder may adopt the language around food sensitivities to justify limiting their diet without anyone “catching on.” For example, they might claim they are sensitive to dairy and thus refuse to eat ice cream and cheese, when really the motivation is to avoid foods high in fat. Sometimes this is conscious– sometimes it isn’t!
With a food sensitivity, there is no need to cut out entire food groups. Food sensitivities can be something as benign or specific as paprika, which does not typically make it onto a feared food list when fighting an eating disorder. Treatment for a food sensitivity may involve an elimination diet, where certain foods are removed from the diet for short periods of time. However, the goal long term is to add as many foods back as possible without producing symptoms.
Other warning signs that it may be an eating disorder, not a food sensitivity include losing weight rapidly or losing your period. Some weight loss may occur with a food sensitivity if someone is struggling to find foods to eat that don’t trigger symptoms, but is typically slower and over longer periods of time. Amenorrhea, or losing your period, is a sign that your body weight is too low or that you are malnourished.
Digestive discomfort is common for both food sensitivities and eating disorders
One tricky symptom that is common for both food sensitivities and eating disorders is digestive discomfort. With a food sensitivity, you may experience gas, bloating, heartburn, constipation, or diarrhea after eating a trigger food. Restricted eating from an eating disorder can produce very similar symptoms. However, the reason for the symptoms is very different in each case.
Digestive symptoms associated with an eating disorder are a result of the restricted eating, not the food itself. Undereating slows digestion because there is no longer enough energy to support your digestive tract. This is called gastroparesis. Gastroparesis can produce uncomfortable feelings of over-fullness, heartburn, bloating, gas, nausea, and constipation.
Resolving digestive discomfort for someone with a food sensitivity involves identifying and avoiding trigger foods. Resolving digestive discomfort for someone with an eating disorder typically involves eating more food so the body is no longer under-nourished and the digestive system can function properly once more.
Can food sensitivities and eating disorders occur at the same time?
Yes. Up until this point, we’ve talked about food sensitivities and eating disorders as separate conditions, but there are some cases where they may overlap.
If you are struggling with an eating disorder and suspect food sensitivities may be involved, step number one is to assemble a treatment team. A physician, therapist, dietitian and psychiatrist, and digestive specialist, if needed. Eating disorders are complex physical and mental illnesses that require the right support. Your dietitian may hold off on food sensitivity testing at the start of your treatment to avoid cutting more foods from your diet.
If you are struggling with a food sensitivity and suspect your thoughts and feelings around food are becoming complicated, seeing a dietitian experienced with disordered eating will be helpful in monitoring risks for developing an eating disorder. Anytime there is intense focus on your eating there is a potential for dipping into disordered eating. Navigating food sensitivities can be very triggering.
For additional help in figuring out if you are struggling with food sensitivities or an eating disorder, reach out to our team of eating disorder and digestive/food sensitivity experts.
Dana uses her advanced training in functional nutrition and food sensitivities to help her clients love and trust food again as they heal from years of painful symptoms that have dominated their lives. Co-author of Nourished: 10 Ingredients to Happy, Healthy Eating and Cooking with Food Sensitivities Survival Guide.
