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Anorexia and constipation

Constipation, or not being able to pass stool regularly or completely, is a fairly common condition that many people experience at some point. 

That’s partly because it can happen for many reasons, including a low-fiber diet, dehydration, lack of physical activity, or even making changes to a regular routine, such as traveling or eating or sleeping at different times.5 But constipation has also been tied to anorexia nervosa, as well as other eating disorders.1,3

The mental health condition is known to cause a number of disruptions and issues throughout the gastrointestinal (GI) tract, including the kind of slowed down movement of the stomach and intestines that can lead to constipation.4

4
 minute read
Last updated on 
September 13, 2023
September 13, 2023
Anorexia and constipation
In this article

What is constipation?

Everyone has different bowel movement patterns, ranging from several times a day to a few times per week, and so long as those patterns remain fairly consistent, they’re generally considered healthy.5

But constipation is technically defined as three or less bowel movements per week.5 If these issues persist for several weeks or longer, it's considered chronic constipation.2

Aside from not having bowel movements at all, constipation can be experienced as:2

  • Straining to have bowel movements
  • Having lumpy or hard stools
  • Feeling unable to empty stool completely from the rectum
  • Feeling a blockage that prevents bowel movements
  • Requiring assistance to empty the rectum
Constipation is defined as three or less bowel movements per week.

What causes constipation?

When you eat food, it first passes through the stomach, where it is broken down by powerful acids and other digestive juices. As that byproduct moves from the stomach through the intestines, nutrients are absorbed from it and transported into the bloodstream. The partially-digested food then moves into the colon, at the end of the large intestine, where it becomes waste.5

In the colon, water is absorbed out of the waste, preparing it to pass through the body. But when food sits in the colon too long, it’s possible for too much water to get absorbed, making the waste hard, dry, and difficult to pass.5

There are many factors that can cause the digestive system to act this way, including changes to one's lifestyle or routine, diet, and some medical conditions and medications.5

How does anorexia cause constipation? 

Constipation can occur in people who have anorexia nervosa for several reasons.

The eating disorder has been related to a number of motility (movement) issues along the entire digestive system. Intestinal transit extension, or the prolonged journey of food through the intestines, and a decreased motility of the rectum and anus have all been linked to AN.4 These issues can result in food and waste spending more time in the intestines and colon, which often contributes to constipation.

Many patients with anorexia nervosa may misuse laxatives as part of their disorder. This can also bring on constipation, as continued misuse of laxatives can decrease muscle and nerve response in the intestines.8 Laxative misuse can also result in or lead to trapped gas in the intestines, which can not only contribute to constipation, but cause abdominal pain and encourage an unhelpful cycle of misusing laxatives.8

It's important to be treated for anorexia and not just constipation symptoms.
Get help

Anorexia and constipation treatment

If you or a loved one are struggling with constipation related to anorexia nervosa, the most important thing you can do is seek out proper treatment for AN. Many GI-related issues subside with eating disorder treatment, once disordered eating patterns are addressed and some balance has been returned to the diet.4

Still, as the body adapts to a new eating routine, it’s possible to continue experiencing constipation and other GI issues into early recovery. In these cases, certain foods and dietary measures may be able to help ease the issue.

Doctors generally recommend eating around 25 grams of fiber daily to support healthy colon function and digestion.6 Drinking plenty of water is also important, to aid against dehydration and constipation.5 And some foods can help the body grow the type of bacteria that creates a healthy gut microbiome. 

Foods that can help relieve constipation include:7

  • Popcorn
  • Dried fruit
  • Some nuts
  • Leafy greens
  • Whole grains
  • Apples
  • Bananas
  • Oatmeal
  • Cooked vegetables
  • Hot beverages, like tea

While these foods can be helpful, they represent general recommendations. If you’re in recovery from AN, especially if you experienced severe weight loss, it may not be appropriate—and could possibly be dangerous—to add too many foods to your diet right away.

If you're experiencing GI issues in anorexia treatment or while receiving treatment for other eating disorders, you should speak with your dietician or doctor about your concerns, so you can get advice specific to your particular situation.

Finding help for anorexia nervosa

Anorexia nervosa and other eating disorders are serious mental health conditions that can have a large and lasting impact on many aspects of mental, physical, and emotional health. If you or a loved one are struggling with one of these conditions, it's crucial to seek out help.

AN doesn't go away on its own, and it often gets worse with time. But there are many ways to treat anorexia nervosa.

At Within Health, we strive to help people recover from these conditions by offering highly-specialized care from a multidisciplinary team of experts. These professionals can help create a unique treatment plan based on your specific medical history and needs.

If you suspect you or someone you know may have anorexia nervosa, please reach out to us today. It could be the first step toward a healthier and happier future.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Eating disorders common in patients with chronic constipation. (2020, June 10). Massachusetts General Hospital. Published on June 10, 2020. Accessed online January 31, 2022.
  2. Constipation. (n.d.). Mayo Clinic. Accessed September 2023. 
  3. Jeong, E., Kim, J. A., Kim, B. S., Lee, C. K., Kim, M., & Won, C. W. (2021). Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS). International Journal of Environmental Research and Public Health, 18(11), 5754.
  4. Weterle-Smolińska, K. A., Banasiuk, M., Dziekiewicz, M., Ciastoń, M., Jagielska, G., & Banaszkiewicz, A. (2015). Gastrointestinal motility disorders in patients with anorexia nervosa - a review of the literature. Psychiatria Polska, 49(4), 721–729.
  5. Constipation. (n.d.). Cleveland Clinic. Accessed September 2023. 
  6. 5 Foods to Improve Your Digestion. (n.d.). Johns Hopkins Medicine. Accessed September 2023. 
  7. Slattery, E. Foods for Constipation. (n.d.). Johns Hopkins Medicine. Accessed September 2023. 
  8. Laxative Use: What to Know. (2019, October). Cornell Health. Accessed September 2023.

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