Can We Treat Eating Disorders and Gastroparesis Together?

Many eating disorder treatment programs emphasize the sentiment that “food is medicine.”

“Nutrition will restore weight that needs to be restored.”

“Nutrition will fix medical complications.”

“Nutrition will help to maintain your set point theory weight.”

“Nutrition will help your mood disorders and obsessive thoughts to decrease.”

“Eating is the best way to fight the eating disorder.”

Even putting up quotes like, “The best way to fight the eating disorder is to pick up the fork and rebel.”

I find these quotes to be inspiring, choice-based, and recovery minded. I am an advocate for quotes like these to be put up in treatment programs, recovering individual’s rooms, houses, etc.

But, what happens when a chronic illness or a complication of the eating disorder makes it so that the individual cannot take their “medicine?” When they can’t eat?

I was diagnosed with gastrointestinal dysmotility (gastroparesis) after years of restricting, purging, and abusing laxatives. It is a common and can be life-threatening complication of eating disorders. It causes symptoms like nausea, vomiting, severe gastroesophageal reflux disease, regurgitation, bloating, water retention, constipation, diarrhea, early fullness, and so much more. It is hell to live with, and, for many, certain types of foods, eating too frequently, eating certain groups of food, eating a high volume of food, or even eating at all, can cause vomiting, extreme pain, or extreme nausea.

People with dysmotility or gastroparesis have delayed gastric emptying, meaning it takes them hours to days longer to digest a meal than it would for the average person due to a partially (or in some cases, completely) paralyzed digestive track.

How do people who have both an eating disorder and dysmotility balance eating disorder recovery?

At my medically sickest, I could not keep anything down. I wanted to eat more than anything, I wanted to leave the hospital, mentally I wanted to fight off my anorexia, but I couldn’t because of my dysmotility. I would be plagued with bloating after every meal, vomiting occasionally, not going to the bathroom for weeks, and pain so intense I would not leave the bed.

Most eating disorder programs are not equipped to treat people with gastrointestinal illnesses or chronic illnesses, even though they are common complications of eating disorders.

I wonder how we could shift from medical and behavioral stabilization to improvement of quality of life?

I have thought about the idea of treating both gastroparesis and eating disorders together, in the same treatment program. What if we were able to treat both diseases at the same time? How many people would be able to get the treatment they needed and not fall through the cracks of the system?

Since getting to a place where in eating disorder recovery where we do not have fear foods and we are able to intuitively eat is often the goal, where do people with gastroparesis fit in? Many people with gastroparesis do not get hunger cues, and cannot eat certain foods.

My article is just one voice. For many, eating disorder recovery is truly about learning to intuitively eat again. But, for me, as someone who struggles with dysmotility, it is not. For me, recovery is about being able to sit with food inside of me, cope with the physical sensations and pain, and work through the waves and guilt. For me, recovery is about physically keeping food down. Of course, there is so much more to recovery for me than just those few ideas. But, my idea of recovery looks different than many treatment programs for eating disorders ideas of recovery look like.

I wish we could start the discussion about treating gastrointestinal issues like gastroparesis that coexist with eating disorders.