It is estimated that one million Australians have an eating disorder and the numbers are rising. Women and girls are twice as likely as men to be affected at some point in their lives.
It is possible to have more than one eating disorder at the time and it is common for women and girls with an eating disorder to also suffer from other mental health issues such as depression and anxiety.
There are still a lot of misconceptions about eating disorders in our society, such as seeing eating disorders as a choice or a cry for attention, driven by a preoccupation with body image. In recent years, however, research has shown that an eating disorder is a serious mental and physical disease. It proves to be more biologically complicated than realised, impacting psychological, cognitive and social functions of the sufferers.
This has caused a new direction in research that associates gut microbiome (trillions of microbes in our gut) and eating disorders. The discovery that gut microbes can modulate mood and behaviour, and that our nervous system interacts with our digestive tract is not new. However, using a gut-brain axis to develop new treatment options for mental illnesses is a new and very active area of research (and particularly relevant to eating disorders).
This makes a lot of sense as our microbiome is influenced by our diet. Extreme eating patterns, stress, and changes in metabolism that occur with eating disorders strongly will affect our microbiome. As a consequence of disordered eating, the gut microbiome changes and there is decreased diversity of microbes. This in return affects metabolism, hunger, and satiety. These metabolic issues contribute to depression and anxiety which further affects eating behaviours, continuing the vicious circle.
On top of this, research into the connection between gut microbiome and eating disorders found that altered gut microbiome also affects a patient’s recovery process. We know that diverse microbiota is needed for proper digestion. In their process of recovery, patients often experience painful gas, abdominal discomfort, and vomiting. This can result from a decreased number of microbes in their gut.
Treatments aimed to restore intestinal microbiota should, therefore, be part of a treatment plan for patients with eating disorders. Nutritionists should be included in a multi-disciplinary team helping clients with recovery.
Tina Henwood is a Nutritionist Health Space Mosman, and is an Australian Centre For Eating Disorders Approved Practitioner.