Gastroparesis and Eating Disorders

Gastroparesis is a stomach condition that is highly prevalent within the eating disorder community. The term “gastroparesis” directly translates to “stomach paralysis.” This condition acutely affects the normal movement of the stomach muscles. Perhaps you or a loved one suffers from gastroparesis, or maybe this is your first introduction to the condition. Regardless of your baseline understanding, this comprehensive overview aims to expand your awareness so that you can identify symptoms and recognize the link between gastroparesis and eating disorders.

What is Gastroparesis?

Gastroparesis is a condition that affects the stomach muscles, causing the rate of muscle contractions to slow down considerably. During the normal digestion process, strong muscles in the walls of the stomach contract to drive food into the small intestine. However, for someone with gastroparesis, the stomach muscles don’t function with their normal strength. This means that food and liquids remain in the stomach for long periods of time, holding up the entire digestion process.

Gastroparesis is underdiagnosed, so its prevalence can only be estimated. Recent studies suggest that it affects roughly 5 million people in the United States (IFFGD). Those who have eating disorders characterized by food avoidance or restriction, such as anorexia, bulimia, and ARFID, are known to experience gastroparesis at higher rates than the general population.

Other high-risk populations include (Cedars Sinai):

• Those with Type 1 or 2 diabetes
• Those with nervous system disorders, such as Parkinson’s disease
• Those who have had surgery on their stomach or small intestine, and thus are more at-risk for damage to the vagus nerve, which controls the stomach and intestine muscles
• Those who have had certain cancer treatments, such as radiation therapy, on their chest or stomach area
• Those who take medicines that may slow movement in the intestine, such as narcotics for chronic pain

How Do Restrictive Eating Disorders Lead to Gastroparesis?

Gastroparesis is extremely common in those who have restricted their food intake. In fact, it is one of the most common physical symptoms of a restrictive eating disorder. When someone is restricting food for a long period of time, the lack of essential nutrients can cause the entire body to lag in an attempt to conserve energy. Just as the heart rate, blood flow, and brain functioning all slow during nutritional deprivation, so do the contractions of the stomach and intestines, contributing to gastroparesis. 

In a study among people with anorexia nervosa and gastroparesis, researchers found that food remained in the stomach for four hours or even longer—roughly twice as long as what’s standard.

It’s worth noting that gastroparesis can occur in those of all shapes and sizes, not just in individuals classified as clinically underweight. 

What are the Symptoms of Gastroparesis?

The symptoms of gastroparesis range from mild to severe. The most common physical effects of delayed stomach emptying include:

• Early satiety, or feeling very full after a small amount of food
• Bloating and upper stomach pain
• Abdominal distention
• Poor appetite
• Constipation and infrequent bowel movements
• Upset stomach or nausea
• Vomiting
• Heartburn or GERD (gastroesophageal reflux disease) 

What are the Complications of Gastroparesis in the Context of Eating Disorders?

The symptoms of gastroparesis may be particularly worrying in the eating disorder setting. For those with an eating disorder, specifically those who have body image concerns that focus on their appearance, a distended and bloated stomach can be stress-inducing. What’s more, someone in recovery who is learning to listen and trust their body’s hunger cues may find that particularly difficult when dealing with stomach pain and early fullness. 

The symptoms of gastroparesis may also trigger an eating disorder not previously present. Patients who report gastroparesis symptoms are found to have higher rates of ARFID (Murray et al., 2019). The discomfort present in gastrointestinal tract (GI) symptoms can cause an individual to restrict eating, which in turn puts them at greater risk for both an eating disorder and intensified GI symptoms.

Treatment for Gastroparesis in the Context of Eating Disorders

Treatment for gastroparesis in an eating disorder setting begins with treating what is often the underlying condition: the eating disorder. A person experiencing gastroparesis alongside an eating disorder should seek treatment from a team familiar with both conditions.

In most cases, the combination of a meal plan with easily digestible foods paired with medications meant to stimulate the stomach muscles and/or medications to ease nausea and vomiting can effectively treat and manage gastroparesis.

Trying to increase nutritional intake in the face of gastroparesis can be challenging. If you or someone you know has an eating disorder and gastroparesis, the first step is seeking help and connecting with professionals. Know that The Emily Program’s expert multidisciplinary team is here to make the recovery process easier in the setting of gastroparesis.

The Emily Program takes a personalized approach to eating disorder treatment and recovery. Please give us a call at 1-888-364-5977 to learn more about the care we offer.