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
- 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
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