Welcome Back to the Conversation
If you’re just joining, Part 1 of this series explored the connection between IBS, elimination diets like Low FODMAP, and the potential risk of over-restriction.
This conversation is part of a broader effort to bring awareness to eating disorders—conditions that are often misunderstood, underdiagnosed, and sometimes unintentionally reinforced in the pursuit of “feeling better.”
And when it comes to IBS, that overlap matters.
When Symptom Management Becomes a Risk
As we discussed previously, dietary changes are often part of IBS management. Approaches like the Low FODMAP diet can be incredibly helpful when used correctly—but they are also restrictive by nature.
That’s where awareness becomes critical.
Medical nutrition therapy can absolutely support symptom relief—but without the right structure and guidance, it can also contribute to unintended patterns of restriction, rigidity, or food-related anxiety.
This is why building your “dream team”—including a registered dietitian, medical provider, and often a therapist—is so important when making dietary changes for IBS.
Eating Disorders Are Multifactorial
While dieting is a well-established risk factor for eating disorders, it’s not the only one.
According to the National Eating Disorders Association (NEDA), eating disorders develop through a combination of biological, psychological, and social factors. Understanding your personal risk can help you—and your care team—create a more thoughtful and preventative approach to dietary changes.
Recognizing Common Risk Factors
Rather than viewing risk as a checklist, it’s more helpful to think of it as a pattern.
Biological Factors
Some individuals may have a higher baseline risk due to:
- A family history of eating disorders
- A family history of mental health conditions like anxiety, depression, or addiction
- A personal history of repeated dieting
For individuals with IBS, repeated attempts to “fix” symptoms through diet alone can unintentionally reinforce this cycle.
Psychological Factors
Certain personality traits and experiences can also play a role, including:
- Perfectionism, especially setting unrealistically high expectations
- Body image dissatisfaction
- A personal history of anxiety
- Behavioral rigidity or difficulty with flexibility
These traits can make structured diets—like Low FODMAP—feel safer or more controllable, but also harder to step away from when needed.
Social and Environmental Factors
Our environment matters more than we often realize.
Risk can be influenced by:
- Weight stigma or pressure around body image
- Teasing or bullying, especially related to weight or food
- Loneliness or isolation
- Past trauma
Layer these factors onto a chronic condition like IBS, and it becomes easier to see how food can shift from being a tool for nourishment to something that feels stressful or overwhelming.
A Special Consideration: Orthorexia
For individuals managing IBS or following elimination diets, orthorexia is an important—and often overlooked—consideration.
Orthorexia is characterized by an obsession with “healthy” or “clean” eating. While it’s not formally classified as a diagnosable eating disorder, its impact is very real.
Because dietary changes for IBS are often framed as “healthy,” orthorexia can sometimes go unnoticed—or even be unintentionally reinforced.
Over time, what starts as symptom management can shift into:
- Eliminating more and more foods
- Feeling anxious about food choices
- Avoiding social situations involving food
- Spending significant time thinking about what is “safe” to eat
Signs That Something May Be Off
It’s not always obvious when helpful changes become harmful.
Some signs that dietary changes may be becoming overly restrictive include:
- Constantly checking ingredient lists or food labels
- Increasing concern about food quality or purity
- Eliminating entire food groups beyond what is medically necessary
- Feeling limited to only a small number of “safe” foods
- Experiencing distress when preferred foods aren’t available
- Spending excessive time planning or worrying about food
Body image concerns may or may not be present, which is why these patterns can sometimes be missed.
Moving Forward with Awareness
If you’ve never followed a diet before, navigating IBS dietary changes may feel more straightforward—though guidance is still important.
But for many people, especially those with a history of dieting, this process can be more complex.
Taking time to:
- Evaluate your personal risk factors
- Build a strong support team
- Stay flexible in your approach
…can make a meaningful difference in both symptom management and overall well-being.
Final Thoughts
Managing IBS is rarely about one single solution—and more restriction isn’t always better.
With awareness, support, and a balanced approach, it’s possible to use tools like the Low FODMAP diet without compromising your relationship with food.
And if any of these patterns feel familiar or concerning—for yourself or someone you care about—you’re not alone. Reaching out to a trained professional is an important and empowering next step.
Stay tuned for Part 3 of this series.
- Eating Disorder Hope. (n.d.). Dieting and eating disorders statistics. https://www.eatingdisorderhope.com
- Gibson, P. R., & Shepherd, S. J. (2010). Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology, 25(2), 252–258. https://doi.org/10.1111/j.1440-1746.2009.06149.x
- National Eating Disorders Association. (n.d.). Orthorexia. https://www.nationaleatingdisorders.org
- National Eating Disorders Association. (n.d.). Risk factors. https://www.nationaleatingdisorders.org
- Staudacher, H. M., & Whelan, K. (2017). The low FODMAP diet: Mechanisms and efficacy in IBS. Gut, 66(8), 1517–1527. https://doi.org/10.1136/gutjnl-2017-313750
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