Anxiety digestion eating disorders

A new perspective on anorexia

1. It’s not all in the mind. 
The way we view anorexia has not changed much over the years. Despite the progress made in medical science we still have an archaic view of anorexia. It is presumed to be caused by a combination of genetics and an idealised perception of thinness along with wider familial complications that cause the disease. This ignores the important role that brain biochemistry and malnutrition play in both the development of anorexia and the continuation of the disease despite ‘treatment’. Anorexia is not primarily a psychological issue it is a biochemical one. It is not all in the mind.

The heightened anxiety, the need for control and OCD problems are all firmly brain biochemistry issues. Brain biochemistry can be influenced by malnutrition and poor digestion and gut flora. The brain biochemistry requires a delicate balance of nutrients, amino acids and co-factors to function optimally. This is not optimal in people who develop eating disorders. The subsequent starvation and malnutrition can take this brain chemistry imbalance to whole new level. This makes anorexia difficult to recover from without rectifying brain chemistry. It is why anorexia nervosa claims more lives than any other psychiatric disorder.

2. Weight gain shouldn’t be the main goal. 
Focusing on weight gain as a main goal is not helpful. Those with anorexia are more likely to participate actively in their recovery once you begin balancing brain chemistry. As the anxiety and need for control lessen, the patient with anorexia begins to want to recover. Patients with anorexia can be scared of weight gain, which is why to focus on that is not conducive to helping them. Helping them overcome their fear and anxiety about weight gain is a better approach.

3. Pain and discomfort from food is real.
It is not unusual for people with anorexia to suffer with pain, discomfort and bloating when eating. This is not imagined and is not simply an excuse not to eat. A lack of the right nutrients to make digestive enzymes and stomach acid secretions can cause discomfort and bloating. This makes eating a unpleasant experience. If you struggle with anorexia it is a good idea to arrange to be screened for celiac disease. Celiac disease, can not only cause malabsorption and digestive disturbances but it can manifest as psychiatric and neurological issues too.
There is a less-well known condition called non-celiac gluten sensitivity which may also contribute to the development of anorexia amongst other conditions. A lack of the digestive enzymes to process gluten and casein can affect neurological development in the same way as it does with autism. Digestive enzymes are a useful therapy in this instance.

4. An almost unheard of metabolic disturbance can cause anorexia.
I recommend all of my clients presenting with eating disorders or a history of them to run a simple urine test measuring the level of kryptopyroles in the urine. If the level is high, we assume that they have a metabolic disorder known as pyroluria. Pyroluria, can run in families and can cause a number of disorders – Asperger’s, depression, anxiety, phobias, suicide attempts, OCD, addictions and eating disorders. Pyroluria, causes the body to excrete higher levels of zinc and B6 than usual. Overtime this causes a deficiency which goes on to manifest as the conditions listed above. Although the effects are primarily neurological, disturbances in digestion and issues with food (from problems eating it and digesting it to food intolerances) are usually present too.

5. Nutritional therapy can help in a different way. 
Nutritional therapy contributes to the recovery of someone with anorexia in a different way to dieticians or nutritionists. We run tests to look at the biochemistry or the individual, look at nutrient deficiencies and identify the state of their digestion. Initially, we use supplements to rectify imbalances. When the patient begins to feel better then they are more likely to take part in their own recovery programme. Nutritional therapy works well alongside other therapies and can make a huge difference to the success of treatment and the likelihood of a relapse.


    Sarah is a clinical nutritionist specialising in mental wellbeing and the gut-brain connection.

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