Food intolerances and eating disorders

The prevalence of food allergies in children, adolescents and young women appears to be higher and higher (Tang & Mullins, 2017).

The number of people who define themselves as “allergic” to certain foods is overestimated both due to the inappropriate use of the term “allergic” and because it tends to explain very different symptoms or pathologies, with allergy or intolerance to certain foods .

This has helped to create the common belief that food intolerance can explain extremely different disorders and symptoms (from simple migraines, irritable bowel syndrome to serum-negative arthritis) that do not yet have an etiology confirmed by the presence of specific biomarkers.

The Ministry of Health itself has published a document (“Food allergies and consumer safety – Guidance document and state of the art Italy 2018”), where a series of tests are collected that evaluate presumed food intolerances, but which have no scientific validity .

Strictly following unnecessary dietary restrictions can have disturbing and sometimes harmful physical consequences. Especially in pediatric subjects there can be problematic consequences also from a psychological point of view.

In a study conducted by Dalle Grave et al. (2008), in fact, cases of anorexia nervosa developed in individuals who followed the dietary indications of a food intolerance test have been described .

A gateway to eating disorders?

Today we know that in the digestive system there are numerous nerve cells that “communicate” with brain neurons and even seem capable of influencing each other (Michael Gershon, 2020) through the vagus nerve.

Some gastrointestinal symptoms, including dyspepsia (in the absence of organic damage), are often caused by stressors and not by the intolerance of certain foods.

Young women or normal weight adolescents who complain of gastrointestinal symptoms whose explanation is given to food intolerances, can however start diets that involve the elimination of numerous foods . This restriction aims to reduce dyspeptic symptoms, but may in some individuals increase the risk of developing an eating disorder .

Following a strict diet, in fact, can facilitate the shift of control from general aspects of life towards a predominant control over nutrition: I control nutrition to regain control that I have lost or cannot find in other areas of life .

From diet to actual eating disorder

Thus we begin to invest excessively in the evaluation of nutrition control , which leads to even more stiffening of food and diet rules. This causes low weight associated with symptoms of malnutrition including a sense of premature fullness linked to slowing gastric emptying.

Selective attention to abdominal sensations leads to increased nutrition control (which initially had a benefit to gastrointestinal symptoms). But this time it exacerbates the symptoms of malnutrition, thus trapping the person in a real eating disorder .

Furthermore, since the reduction in caloric and food intake (such as carbohydrates or dairy products) often leads to a reduction in gastrointestinal symptoms in the short term, it favors the formation of extreme and rigid cognitive dietary rules.

Maintaining constant adherence to these dietary rules is difficult and in the long run, impossible. The inability to maintain control over the imposed rules can be interpreted by some people as an obvious lack of self-control . This leads to the temporary abandonment of feeding control, causing real binges .

These are followed by escalations of concerns about weight and body shape that encourage further dietary restrictions. Again we find ourselves trapped in a complex mechanism: an eating disorder .

What is the correct attitude towards food intolerances or allergies?

It is important to always contact expert allergists who can verify the real presence of food intolerances and recommend medical tests of certain scientific validity.

If we are facing a full-blown eating disorder and food intolerance, how to move?

Also in this case, a medical evaluation by an allergist who can confirm the real presence of an intolerance is advisable.

If this pathology is not confirmed, as in most cases it happens, it is important to help the person suffering from an eating disorder to undertake an evidence-based psychological path such as CBT-E (Dalle Grave, Calugi & Sartirana, 2018).

This treatment will help the person cope with excessive concerns about certain foods. It also creates a wider self-assessment system that is not predominantly based on the control of nutrition, weight and body shapes .

 

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