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Learn more about the results we get at Within

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Why does anorexia bloating occur?

While not an official medical term, “anorexia bloating” can be used to describe bloating that occurs as a symptom of anorexia nervosa (AN). 

The issue can be a byproduct of gastrointestinal issues connected to AN or be caused by other disordered behavior related to the condition. “Anorexia bloating” is also common during eating disorder recovery, due to bodily changes that frequently occur during the refeeding process.

Our program can help

86% of our patients reported an improved quality of life post treatment.

How we do it

The best way to treat anorexia bloating is by addressing the AN itself. In many cases, bloating will subside with sustained and healthy weight restoration.3

Last updated on 
August 14, 2023
August 14, 2023
Anorexia bloating
In this article

What is bloating?

Bloating is a relatively regular occurrence in the gastrointestinal (GI) tract, generally leading to a distended (expanded) stomach and mild to severe abdominal pain. 

By and large, bloating is the result of excess intestinal gas in the GI tract. It often feels like an uncomfortable fullness or tightness in the abdomen and frequently occurs alongside acid reflux.

In general, bloating can be related to a number of issues, including:2

  • Eating too fast or too much
  • Digestive distress, including from food intolerances
  • Constipation
  • Hormonal fluctuations connected to the menstrual cycle
  • Irritable bowel syndrome (IBS)

Bloating is very common, with up to 25% of people reporting occasional issues with the condition, and the gas usually passes on its own, with time.2

However, there may be situations where bloating indicates a deeper medical issue and should be addressed with appropriate treatment. If symptoms don’t go away, get worse with time, or include additional complications like vomiting, you should seek out further care.2

What causes anorexia bloating? 

The disordered eating behavior involved with anorexia nervosa tends to cause a number of GI issues, some of which can lead to bloating.

Delayed gastric emptying has long been associated with AN and other eating disorders, including bulimia nervosa (BN).3 Also called gastroparesis, the condition involves the prolonged emptying of the stomach. When this occurs, it can back up the rest of the digestive system, including any food that may be moving through the small intestine.4

As food is passed through the intestines, it’s broken down by healthy gut bacteria, and intestinal gas is a natural byproduct of this interaction. But the longer food sits in the tract, the more it ferments, leading to more gas production — and, in many cases, instances of bloating.2

Similarly, studies have linked AN to delayed whole-gut transit, or the journey food takes along the entire digestive tract, from ingestion to expulsion. This has been connected not just directly to bloating but to constipation, which can contribute to bloating.5

And while more work is needed to understand why gastroparesis co-occurs so frequently with anorexia nervosa, the condition has been connected to a restricted dietary intake and various nutritional deficiencies, which are hallmark symptoms of AN.6

Electrolyte imbalances caused by disordered eating patterns can also potentially lead to bloating, along with issues related to laxative misuse.9

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Other issues connected to anorexia bloating

Bloating is generally uncomfortable, and it can be painful. But unfortunately, it can have more than just physical effects for people struggling with AN and other eating disorders.

Some studies on the issue have warned that bloating may trigger the fear of weight gain for people with AN, as they see their stomachs protrude.5 This could potentially lead to further food restriction or fuel other unhelpful thoughts or actions connected to the disorder. 

Bloating is also a frequent symptom of refeeding in people with AN. In many cases, this can be connected not to gas build-up but water retention, as the body shifts fluids around in an attempt to rehydrate during the refeeding process.7

Again, the danger of bloating occuring during refeeding is the potential of triggering unhelpful thoughts or behaviors related to the fear of gaining weight. Patients may also feel less inclined to eat if they feel uncomfortable from bloating.7

Finding help for anorexia bloating

The best way to treat bloating when it’s connected to anorexia nervosa is by addressing AN itself.

Research has shown that delayed gastric emptying and other upper GI issues related to AN will subside on their own with healthy weight gain.3 And getting adequate nutrition can help balance out any vitamin deficiencies that may contribute to the problem.

And for those already in treatment, there are additional options to help reduce bloating in anorexia recovery.

Studies that show that the right mixture of probiotics—substances that help support healthy digestive enzymes—can work to reduce bloating, though these findings have been inconsistent.1 It may be beneficial to discuss this option with your doctor before starting on a probiotic regimen.

Other natural approaches to alleviate bloating include abdominal massage, warm baths, and taking peppermint capsules, with the herb known to soothe the intestinal tract.8

Get help for anorexia nervosa

Help with bloating is far from the only reason why it’s a good idea to seek out treatment for anorexia nervosa. The condition is dangerous, and can be deadly if left untreated.

If you or a loved one are struggling with AN or another eating disorder, it’s important to seek out help. Your primary care physician or therapist can be a great place to start, with these experts able to help you secure an official diagnosis or determine your next best steps.

At Within Health, we also strive to help. Our multifaceted eating disorder treatment team can help address the many physical and psychological issues associated with AN. And our unique program allows you to follow their tailored treatment plan, all from the comfort of your own home.

Battling anorexia nervosa may feel overwhelming, but it’s important to remember that recovery is always possible.

Call (866) 293-0041

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. Ringel-Kulka, T., Palsson, O. S., Maier, D., Carroll, I., Galanko, J. A., Leyer, G., & Ringel, Y. (2011). Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study. Journal of Clinical Gastroenterology, 45(6), 518–525.
  2. Bloated Stomach. (n.d.). Cleveland Clinic. Accessed July 2023. 
  3. Rigaud, D., Bedig, G., Merrouche, M., Vulpillat, M., Bonfils, S., & Apfelbaum, M. (1988). Delayed gastric emptying in anorexia nervosa is improved by completion of a renutrition program. Digestive Diseases and Sciences, 33(8), 919–925.
  4. Gastroparesis. (n.d.). Cleveland Clinic. Accessed July 2023. 
  5. Kamal, N., Chami, T., Andersen, A., Rosell, F. A., Schuster, M. M., & Whitehead, W. E. (1991). Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology, 101(5), 1320–1324.
  6. Parkman, H. P., Yates, K. P., Hasler, W. L., Nguyan, L., Pasricha, P. J., Snape, W. J., Farrugia, G., Calles, J., Koch, K. L., Abell, T. L., McCallum, R. W., Petito, D., Parrish, C. R., Duffy, F., Lee, L., Unalp-Arida, A., Tonascia, J., Hamilton, F., & NIDDK Gastroparesis Clinical Research Consortium (2011). Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis. Gastroenterology, 141(2), 486–498.e4987.
  7. Gibson, D. (2021, May 26). Gastrointestinal (GI) Issues During and After Eating Disorder Treatment. (n.d.). Acute Center for Eating Disorders & Severe Malnutrition. Accessed July 2023.
  8. Berry, J. (2022, December 23). Eighteen ways to reduce bloating. Medical News Today. Accessed July 2023. 
  9. Decker, E. (2022, September 20). How to Cope with Bloating During Eating Disorder Recovery. Erin Decker Nutrition. Accessed July 2023.

FAQs

How long does bloating last in anorexia recovery?

Everyone experiences recovery differently, so it can be difficult to estimate how long someone may deal with bloating and other GI issues during this period. Bloating may last throughout recovery or appear periodically, though the restoration of a healthy weight usually puts an end to this issue.

Still, it may be possible to help reduce bloating throughout recovery by eating foods low in fiber, and following a healthy and consistent meal program.9

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