Elimination Diets in Eating Disorder Recovery
Written by CCTC Staff Writer
Navigating food sensitivities or allergies while in recovery, or actively struggling from an eating disorder or disordered eating can be complicated. Taking careful consideration of your history to make choices that support your health and wellbeing is imperative.
In this article, we’ll discuss:
What an elimination diet is
How elimination diets work
What alternative options are available
Risk of disordered eating & elimination diets
How to balance a healthy relationship with food while eliminating certain foods
The intersection of wellness culture and food intolerances
What is an Elimination Diet?
When trying to determine what foods you are sensitive or allergic to, an elimination diet may be used. This is essentially a meal plan that avoids or removes certain foods and ingredients to determine what may be affecting you. Elimination diets are believed to help uncover the cause of symptoms such as persistently dry, itchy, skin (dermatitis) and stomach discomfort.
While this may be helpful in certain situations to determine what food may be contributing to challenging symptoms, there are certain precautions that should be taken that may not always be considered by providers. Unfortunately, many doctors are not educated on the prevalence and seriousness of eating disorders and disordered eating and may make recommendations without considering the harm that may be done.
How does an Elimination Diet work?
An elimination diet is broken into two different phases. The first being the elimination phase and the second being the reintroduction phase.
In the elimination phase one would stop eating any suspicious foods that are suspected to be triggering symptoms. Your doctor would likely have you record what you eat and any symptoms that you experience. In the reintroduction phase, you’d slowly add these eliminated foods back to your diet to see if any symptoms arise. This is sometimes referred to as the “challenging” phase where you introduce food groups one at a time. After that, you’d once again stop eating foods causing problems to shrink the list to determine what may be contributing.
Disordered Eating & Elimination Diets
One study on women ages 25 to 45 found 31% of women without a history of anorexia or binge eating reported having purged to control weight, and 74.5% of women reported that their concerns about shape and weight with their happiness. These disordered behaviors, and negative attitudes about weight and body image are not uncommon. And these certainly extend beyond this demographic of women between those ages. Disordered eating affects people of all genders and identities and ages.
An elimination diet can cause someone to revert back to restrictive behaviors while in recovery, or to trigger some into the cycle of disordered behaviors for the first time. Even if one hasn’t struggled previously, if they have certain vulnerabilities to develop an eating disorder, an elimination diet can easily slide into a more serious situation of restriction.
As Christy Harrison MPH, RD, CEDS says, “if you already have some restrictive thinking about food (which most people living in diet culture do), an elimination diet is like pouring gasoline on the fire.”
Are there alternatives to Elimination Diets?
While blood or skin tests cannot provide all answers and are sometimes not totally reliable, it can help in the diagnosis process and may be a suitable alternative if you are in recovery or have a history of disordered eating.
Food Intolerance and Wellness Culture
Have you noticed the many gluten-free products in the grocery store, or heard countless people in your life mention they are going gluten-free due to a sensitivity? While everyone has their own experiences and some people may have true allergies and illnesses, did you know only 1% of people have celiac disease worldwide? Elimination diets are even promoted by wellness gurus and influencers.
This is an example of where the overlap of diet culture, wellness culture and food intolerances overlap. It is important to consider the way any type of choice you are making regarding your health will, or is, impacting you. In an effort to improve your health, you may think eliminating certain food groups is best, but how is this impacting your mental health? Your overall wellbeing is important.
What if I do have to eliminate something from my diet? How do I do that while trying to adopt an Intuitive Eating attitude towards food?
The ultimate goal of Intuitive Eating is to learn how to trust yourself and your body to know when to eat, what to eat, and let go of rigidity and rules around food. Within this, the goal is to also let go of labels on food. Food moralization, or looking at food as good vs bad, healthy vs unhealthy, can complicate our relationship with food.
But how do you let go of labels and allow yourself all types of food if you discover you have an intolerance or allergy?
This can be complicated to navigate. First, make sure your provider that is making this suggestion is aware of any history of disordered eating and eating disorder diagnosis. Transparency of your history can ensure the provider you are seeing is utilizing alternative methods to determine what to eliminate.
The last principle of Intuitive Eating is Honor Your Health - Gentle Nutrition. What does this mean? Making food choices that honor your health and taste buds while making you feel good. How does this apply to needing to eliminate certain foods or food groups due to allergies or sensitivities? By shifting your perspective from a view of it being a deprivation of that food, it may be helpful to think of it as a way of honoring your body and helping it function at its best.
If you are in recovery, it may be worthwhile to consult a registered dietitian that specializes in eating disorders to get their support during this process.
How to talk to your provider about your history of disordered eating
Discussing your current or past disordered eating symptoms may be an uncomfortable topic to address, but it is incredibly important to speak openly and honestly. When it comes to making treatment decisions and recommendations regarding possible food intolerances and allergies. This information will allow them to best support you. Here are a few ideas on how to address it, but of course, determine what feels right for you:
“Before we talk about why I’m here today, I do want you to know that I have a history of disordered eating.”
“I have been diagnosed with (Anorexia, Bulimia, Binge Eating Disorder, or an Eating Disorder) and currently/previously am receiving/are receiving treatment so I thought that would be helpful for you to know before we get started.”
“I want to make sure that I am cautious about eliminating food because of my history of/current struggle with disordered eating.”
If you are currently seeing a therapist or any other providers to treat your eating disorder, you can ask them if they have any referral suggestions with other providers that are aware of how to deal with any issues you are dealing with while being sensitive and cautious to support your eating disorder recovery.
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or simply learn more about the holistic, flexible eating disorder recovery programs we offer.