The Downside Of Elimination Diets
I want to revisit a topic I brought forward a few years ago: The connection between elimination diets, such as Autoimmune Protocol (AIP), low-FODMAP, low-oxalate, low-histamine, Atkins, Keto, and Paleo, among others, and disordered eating.
Few people talk about this or even acknowledge it, but my own experiences with real clients living the struggle make it a required discussion.
By definition, elimination diets revolve around a series of rules that frame how much or how little of a given food someone’s allowed to consume. Whether targeting gluten, refined flour, sugar, dairy, protein, grains, legumes, nightshades, etc., all claim to improve health by decreasing consumption of (or avoiding altogether) what each considers “bad” foods, while increasing consumption of “good” ones.
Unfortunately for many followers of these diets, they can easily lead to disordered eating.
What starts out as a short-term effort to avoid certain inflammation-causing foods quickly becomes an obsession with restrictive eating. Disease remission, life, and death come to hinge on “restricting harder,” resulting in the elimination of vast categories of food, severe anxiety associated with eating, and internal shame tied to a lack of sufficient will power.
The Path To Disordered Eating
Far too many of my clients – and millions of others – have found themselves well down this path and struggling. Signs might include the following:
Allowing themselves to eat only a handful of foods
Avoiding social outings, due to the stress and discomfort tied to food
Binge eating on “cheat days”
Feeling trapped by food and scared of dietary deviation
Feeling disappointed in themselves for failing to adhere
Scared of the physical and emotional fallout from “breaking the rules”
The six stages of an elimination diet for far too many.
Here’s an example of what I commonly see, pulled together from threads of numerous clients and colleagues with whom I’ve talked. It isn’t just about a “healthy diet;” instead, it comes to be about an individual’s power to be restrictive enough with food and strong enough of mind to heal themselves at all costs.
Meet Linda, a 48-year-old with Multiple Sclerosis who’s been experiencing more frequent and severe MS flares in the last two years.
Stage 1: Motivation
Highly motivated to change her circumstances, Linda decides to “take her health into her own hands.” Like so many others before her, she quickly finds her way to the AIP diet online. Inspired, but nervous, she leaps into the world of restrictive eating, ready to heal herself and lessen the frequency of flares.
Stage 2: Frustration
After eight months of diligence and vigilance to the ways of AIP, she’s made progress but is still regularly experiencing symptoms. Linda had expectations that she would have made more progress by this point, after having read volumes of online stories about the successes of others. She feels like she’s done something wrong and assumes that she hasn’t been strict enough or hasn’t eaten enough of the right vegetables and nutrient-dense foods.
Stage 3: Recommitment
Linda tries coming off AIP and just being Paleo, by reintroducing a few foods (after all, AIP is supposed to be a temporary diet). But, she flares and feels numbness in her right leg, even though she followed all the reintroduction instructions presented on various AIP websites. So, she decides that she needs to go full AIP again and even decides to remove additional foods like sweet potatoes and plantain chips that she had previously used as “treats.”
Stage 4: Depression
Three months later, with incremental improvement in her latest full AIP try, she reintroduces the same sweet potatoes she used to love. Now, however, she feels numbness in her left leg that she hadn’t felt just three months before. She’s psychologically crushed and begins to fall into a mild depression, wondering how and why her body continues failing her.
Stage 5: Obsession
As her low-level depression builds, Linda becomes more and more fixated on her restrictions, fearing that even one food “mess up” could ruin the small increments of progress she’s made. As a result, she starts:
Eating only foods she’s prepared, because she’s worried that she’ll accidentally eat something “off-limits;”
Purchasing organic food only from stores she knows and trusts;
Spending hours each day thinking about her food, meal plans, and what she may be doing wrong to cause her progress to stall;
Waking up in the middle of the night afraid that any new food may cause her to lose her ability to walk;
Withdrawing from social situations; and, lastly,
Convincing herself that the Universe is punishing her with this disease.
Stage 6: Relief
After 18 months, Linda gets the help she really needs, finding support outside the closed world of AIP. Working with a coach / therapist / nutritionist, she comes to recognize the inflammatory drivers unique to her that are contributing to MS; discovers ways she can work with her fear around food and her diagnosis (rather than against them); and builds a new tool kit to heal the part of herself that believes the only way to manage her fear of flaring is by restriction.
Change Is Within Your Reach
If you hear yourself in these words, know that you’re not alone and that change is well within your reach. I encourage you to take your inner voice to heart and find a professional that can help you sort through your elimination diet experiences, understand what’s happening, and work with you to address the challenges.
Your story is still being written, and you have the opportunity to heal and find profound meaning in your struggles.
https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia
https://www.allianceforeatingdisorders.com/orthorexia-nervosa/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370446/
https://www.self.com/story/orthorexia-how-my-clean-eating-turned-into-anorexia
https://www.healthline.com/nutrition/orthorexia-nervosa-101
https://www.eatright.org/health/health-conditions/eating-disorders/orthorexia-an-obsession-with-eating-pure
https://www.washingtonpost.com/lifestyle/wellness/could-social-medias-healthy-food-focus-be-contributing-to-a-little-known-eating-disorder/2019/07/15/8eb38fbe-9db9-11e9-b27f-ed2942f73d70_story.html