Gut Health and Disordered Eating with Gianna Michalak MS, CNS
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Normally, when you go to someone for this issue, the solutions you’re offered are going to involve a pretty heavy dose of restriction – but Gianna understands that when somebody has a chronic illness, there’s so much that has to do with your immune health and mental health, and sadly, very often, people struggling with this also struggle with eating disorders. So her goal is for you to expand your quality of life – which I love. What a breath of fresh air!
I do want to add that if you’re in the throes of your eating disorder and you struggle with chronic illness, it would be beneficial for you to work with a dietitian who specializes in eating disorders and gut health/chronic illness; some of Gianna’s specific suggestions might not apply to you. Just take all of this with a grain of salt and see what works for you.
So, without further ado, let’s jump right in!
What IS Gut Health?
When we’re talking about gut health, we’re talking about microbes that live in your digestive tract. You can think of it like a city. There are multiple cities in your body – your mouth has a microbiome, your ears have a microbiome – but your gut is going to have the largest city, like New York City. And this microbiome is going to influence your health directly. Weird, right? 🦠
There are a few different functions of your gut’s microbiome, but most simply, it’s going to interact mainly with your immune system and your digestive system. It allows for your body to understand (1) what foods are going to be absorbed in your body and (2) what’s going on in your digestive tract.
So What Does This Mean?
There are many functions of your gut health, but we’re going to focus on one: your digestion.
Your gut health is very important for how your body breaks down the food, but also for how your body absorbs the nutrients from the food. This can influence various areas of your health, like your immune health, your mental health, and even your hormone health.
So, in essence, these microbiomes are tag-teaming with your digestion – how you absorb nutrients and how your body is responding to those nutrients.
Red Flags of Gut Health Issues 🚩
There are a few different symptoms that can tell you your gut health is unbalanced or needs support:
Chronic bloating - occurring a few times a week, and especially if it’s noticeable or painful
Poop problems - constipation, diarrea, or going to the bathroom and feeling like you’re not having complete bowel movements
Acid reflux
Gas
Burning feeling after a meal
So if you’re reaching for Tums more often than not, this is a sign that your digestion might need some TLC.
Clashing of Gut Health and Disordered Eating
So often, when I hear someone struggling with gut issues and disordered eating, it clashes – When they try to work on their disordered eating they’re told “make peace with food,” “all foods fit,” and “avoid restriction!” When they try to address their gut issues they’re told “cut this out,” and “avoid that food!” In essence, what seems to work for one contradicts the other. And then they just stay stuck in both.
Gianna notes that there is a huge amount of the population who experiences gut issues and food anxiety/disordered eating. Why? If you’re eating meals three times a day and there’s an uncertainty of how your body is going to react, oftentimes it’s a negative and anxiety-inducing experience. Plus, all that food restriction can lay the foundation for a complicated relationship with food.
Food Elimination
Within the eating disorder treatment world, whenever someone has eliminated a food group (gluten, dairy, etc.) without a specific allergy to it, it’s generally looked at as disordered.
I’m not saying that’s right or wrong. But I do think that stops conversations that need to happen before they even have a chance.
Gianna says this is the reason why personalized nutrition is crucial. She says the major myth in the gut health space is that you have to eliminate foods to heal your gut – and that’s simply not true.
Gianna cites a study done in 2018 that compared people’s gut microbiomes. People who had the most healthy and vibrant gut microbiome – AKA, a diverse amount of bacteria all living in peace – achieved this not through food elimination, but by diet diversity. So eating a vibrant, colorful diet through a variety of different foods is most important to achieving gut health.
Development of Disordered Eating after Gut Issues
So, why would somebody develop some sort of eating disorder as a result of their gut issues?
There’s two major reasons why this would happen:
The reward chemical component – maybe you have chocolate cake on your birthday or enjoy a pizza. You have a neurotransmitter response to that: you get a dopamine hit, and you feel relaxed, satisfied, and happy. Your gut microbiome produces 86% of the precursors to dopamine. So, if you have gut issues and the bacteria that produces dopamine aren’t there, you have less dopamine. So when you’re eating foods, you’re getting less of a reward mentally, AND the foods are causing you pain. Hence the tendency to restrict.
There’s an emotional relationship with food. If there’s uncertainty around that relationship – betrayal, even – you’re going to have trust issues with food. It doesn’t have to be this way and you CAN regain trust in your body by optimizing your gut health, but it can certainly be frustrating, painful, and debilitating.
Placebo Effect
What would Gianna say to the people who claim that when someone eliminates a food group – like gluten or dairy – and it makes them feel better, that it’s just a placebo effect?
Gianna says when it comes to food intolerance, we don’t really have any biological markers to tell us how food intolerance is affecting the gut. All we can see is inflammation from a stool test.
So if somebody has eliminated dairy, Gianna would have them reintroduce it back in for at least 4-5 days. That eliminates the placebo effect possibility. The questions we then ask are:
How do you feel now that the food has been reintroduced?
How is your energy?
How do you feel mood-wise?
How are your bowel movements?
Then, that person will get to make a decision about that food. At the end of the day, there’s no way to avoid the placebo effect – but it’s so important to tune into what your body is telling you to make decisions about your diet and health.
Is it the Disorder or the Gut?
I think often, when someone comes to me and says they have digestive issues with gluten and they are off gluten, while I believe them completely, there is always a question in the back of my mind that wonders if there is a part of them that secretly feels safer avoiding the food. Are we feeding the eating disorder by continuing to stay off gluten?
If it’s a combination – the body actually has a reaction but it also feels safer to stay off gluten – it becomes so tricky. What do we do about that?
Gianna says it depends on the client, and that it’s so difficult to make a blanket statement about that.
She brings up the example of someone who cannot tolerate gluten in the United States, but then goes on a vacation to Europe and can enjoy the pasta there. There’s one response that says the person is more relaxed because they’re on vacation, so they can digest food better. But there’s a second response that says Italy uses a different type of wheat that has a lower percentage of gluten – so that person can tolerate the food there.
It boils down to two responses: (1) it’s not really the food that’s triggering these negative responses, and (2) it’s the food.
Gianna’s thoughts? She splits the responses.
She compares it to working out, meaning, your digestion can get stronger over time. When you eliminate food, she says there’s a widespread belief that you are going to heal your gut, but that’s not the case. In reality, if you focus on optimizing your gut health and diet, there might be a way to get stronger over time so you can enjoy gluten.
There are so many opinions on this, says Gianna. But at the end of the day, if you optimize your digestion, you can have more freedom with your food.
Where to Start
If you’re having gut health symptoms, like bloating, and you’re experiencing an eating disorder, where would you even begin to try and optimize your digestion?
Gianna suggests adding flavor to meals you already love and have peace of mind with.
Try adding different spices, like paprika, turmeric, and rosemary. You can also add different veggies to optimize a meal.
For instance, if you’re eating pizza, you can add garlic, peppers, red pepper flakes, or mushrooms on the pizza. You’re adding flavor and nourishment to the pizza when you do this.
Small steps lead to big breakthroughs, and this is a way to start building more momentum in your gut health journey.
Gianna’s Journey
I asked Gianna how in the world did she know to start adding spices and flavors to her food to begin healing. Gianna spoke about her journey, and how she started experiencing bloating and discomfort in high school, along with the strictest diet she’d ever been on.
Four years later, she had an autoimmune condition that was getting worse. She describes having a spiritual experience with knowing she needed to make a change.
She spoke to an herbalist and did her own research about superfoods and spices. She then started adding spices and superfoods to her food to get more nourishment in her body.
It was very simple and basic: she would season her chicken patty or potatoes, or add cayenne pepper to her taco dip, or add superfoods to her smoothies. It was easy but enjoyable, and helped her feel like she was making a change, which allowed for sustainability.
She notes that half of the battle is knowing how to cook the food, and feeling comfortable with it. It’s amazing how you roast a potato, zucchini, or squash, and it transforms how you enjoy it – and the same thing applies to seasonings.
BTW, I normally tend to shy away from the term “superfoods” just because I don’t think we can give any specific food that amount of power or credit. I also want to emphasize that this is what worked for Gianna and how she works with others. It does not mean it will be the answer for you. Be sure to seek out your old individualized care to make these decisions.
Major Foods that Trigger Gut Issues
Gianna finds that the following are common for causing sensitivities:
Gluten
Cheese – surprisingly, this is more common than dairy. Cheese has more fat in it, so it can be harder to break down, especially if someone has problems absorbing fat
Foods higher in fiber – these are harder to break down and can trigger issues in people who have slower digestion. Gianna suggests optimizing your gut heath to build up a tolerance to fiber
Mindfulness
Gianna suggests being more mindful while eating. What does this mean?
If you’ve ever watched giraffes and zebras eating on Discovery Channel, you’ve probably noticed that if they ever feel unsafe, they pop their head up, look around, and only go back to eating when they feel safe again. 🦒🦓
This is the same with your brain. Your brain only has two modes: (1) rest and digest, or (2) fight or flight. Your brain can only be in one of these modes at a time, and it sees “rest and digest” as being safe and “fight or flight” as being unsafe. It will put most of its energy and focus on digestion only when it feels safe. Sound familiar to Mya Kwon’s podcast episode?
When we can optimize emotional wellbeing and digestive health at the same time, our body is going to work most effectively.
So, how do you bring in mindfulness? You can:
Breathe before eating
Take your full lunch break
Eating in the kitchen/lunchroom rather than at your desk
Relax during mealtime
When you do this, this allows your body to digest food better. It allows you to actually restore your relationship with food because you’re activating a brain mode of safety.
Your brain and gut together are like a power couple, says Gianna – they’re besties who talk all the time. So when you incorporate this mindfulness into your eating, it really can do wonders for your digestive health.
My note on this? It’s important that this doesn’t spiral into restriction or disordered eating, and this is all so individualized – incorporating lots of different foods in your diet may or may not work for you, so we have to work with you as an individual to figure that out.
Anti-elimination
Gianna emphasizes that she does not jump to elimination. She stresses that what is going to be most sustainable for clients is having a good relationship with food regardless if they eliminate foods or not – and she always starts with them not eliminating foods.
Of course, if clients say something specific like gluten is an issue, they dive into it – but they don’t jump to elimination. There are so many resources outside of elimination, Gianna says, that are going to be supportive of you and where you want to go in healing your gut and your relationship with food.
Tweetable Quotes
“The major myth in the gut health space is that you have to eliminate foods to restore your gut health – and that is simply not true.” – Gianna Michalak
“Let’s say you are reactive to gluten right now. There may be a way that, a year from now, if you focus on optimizing your gut health and your digestion, you CAN have gluten a part of your diet and have peace and satisfaction.”-- Gianna Michalak
“[Mindfulness] actually allows your body to digest food better and it allows you to also restore your relationship with food because while you’re consuming it, you’re activating a brain mode of safety.” – Gianna Michalak