Can You Prioritize Gut Health and Still Make Peace with Food?
Q&A: Gut health and intuitive eating, recovering from binge eating while dealing with irritable bowel syndrome, and more
Welcome back to Rethinking Wellness! In these biweekly Q&A newsletters, I answer audience questions about wellness culture, including whether particular diets are warranted, the truth about supplements and other protocols, how to spot wellness scams, and lots more. You can ask your own question here for a chance to have it answered in an upcoming edition, and some of these Q&As may end up in bonus episodes of the podcast as well.
Just a reminder that these answers are for educational and informational purposes only, and not a substitute for medical or mental-health advice. Although I am a registered dietitian, I’m not your dietitian (unless you happen to be one of my 1:1 clients—hi!—but even then, this email isn’t a session).
Without any further ado, let’s get to the questions!
The first question today is available to all subscribers (about gut health and intuitive eating), and there’s a bonus one for paid subscribers (about working with a naturopath to treat irritable bowel syndrome while healing from binge eating).
I’m in recovery from two-plus decades of dieting and disordered eating, currently working with an eating disorder dietitian. There are certain foods that I have thought were “bad” for a long time, and I’m working with my dietitian on making peace with them. But recently I read an article from a reputable source about how these kinds of foods are harmful to gut health because they (apparently) feed the bad gut bacteria and kill off the good ones. There was an expert quoted about specific foods to avoid for gut health, some of which happen to be foods I’m trying to reintroduce. Is this really true? I want to take care of myself, and there’s so much information out there about how important gut health is for overall health. How does this fit in with intuitive eating?
—Trying to trust my gut
Thanks for this question, and it’s great that you’re working on making peace with food after such a long time in diet culture. I always find it frustrating when articles like this threaten to shake people’s disordered-eating recovery—especially since the evidence for “gut-health diets” is itself very shaky (though you wouldn’t know it by looking at media/social media).
I don’t want to get too far into the weeds here, but there’s ongoing scientific debate about almost everything in the field of gut health. Multiple studies1 in recent years have called into question some of the most fundamental concepts, like how to measure gut microbiomes (the communities of microorganisms living in the gut), what constitutes a “healthy” gut, and how food affects the microbiome.
A recent study highlighted that the current methods used to analyze microbiomes might falsely detect microbial species that aren’t actually there. While the gut microbiome has been studied intensively for more than 15 years, accurately measuring gut microbes and their byproducts remains an immense hurdle. In fact, a 2016 study aptly described the inconsistencies in human microbiome research as leading to “significant misinterpretation of data and confusion in the field.”
For that reason, the classification of gut bacteria as “good” and “bad” is vastly oversimplified and often inaccurate. Several studies, such as this one from 2020, challenged these classifications when they found no difference in the ratio of two key gut bacteria between larger- and smaller-bodied people (because of course gut bacteria are often labeled as “good” and “bad” based on anti-fat bias—more on that shortly.)
These debates show that gut-health research stands on shifting sands. The field is still evolving, and the evidence isn’t anywhere near as airtight as it’s made out to be in the media and on social media. The gut-health hype is far outpacing the science.
So why are there still so many articles and “experts” advising against certain foods for gut health? For one thing, gut health has become a major social-media trend. Algorithms that prioritize engagement can play a role in driving the popularity of wellness trends like gut health, often spreading overhyped preliminary research as well as straight-up misinformation. And mainstream media outlets often clamor to report on whatever is trending on TikTok because they figure there’s a guaranteed audience for whatever they post (they’re not wrong).
What’s more, despite the growth of the anti-diet movement in recent years, I think diet culture is still strong overall. There’s an ongoing appetite for new “plans” and “programs” and “methods,” new ways to lose weight and supposedly achieve health and longevity. They don’t necessarily call themselves diets anymore, but they’re still all about demonizing certain foods and lionizing others, usually in the service of shrinking bodies.
Scratch the surface of gut health and you’ll find a wellspring of anti-fat bias. It can be overt, like the research that pathologizes higher weight and (wrongly) blames gut microbes for it, or slightly more covert, such as before-and-after photos of people’s bloated bellies supposedly shrinking after a gut-health diet. But the message is more or less the same: if you’re anything other than thin with a flat stomach, it’s because you have “bad” gut bacteria (which clearly is not true).
In many cases, gut-health recommendations are just dieting by another name. Old advice is getting repackaged with new rationales: for example, in the 1980s and ’90s, high-fat foods were labeled as “fattening” or bad for cholesterol; now they’re being branded as harmful to gut health. Eating fiber was once pitched as a way to trick yourself into feeling full; now it’s also being sold as a way to promote gut health.
(To be clear, I’m not advocating an all-fat diet or saying fiber is “bad”—there are plenty of reasons why some people might genuinely enjoy and feel good eating lower-fat, higher-fiber foods as part of a peaceful relationship with food where nothing is off limits. Some people who aren’t dieting might even drink green juice occasionally because they like the taste! It’s just interesting to see how the diet-culture rhetoric used to sell those foods has shifted over the years.)
Given all those issues with the concept of gut health—and your own background with chronic dieting—I wouldn’t let these articles make you question your recovery process. Gut-health diets, like other diets, are generally counterproductive when you’re trying to heal from disordered eating. And even if you weren’t actively working to repair your relationship with food, there simply isn’t enough solid evidence behind these diets to recommend them.
I hope you can stay strong in your recovery and keep prioritizing your healing in the face of diet and wellness trends.
Thanks so much for the great question, and thanks to all the free subscribers for reading! Paid subscribers can stick around for the bonus Q&A, and everyone can ask their own questions for a chance to have them answered in an upcoming newsletter.
I’m very interested in gut health and irritable bowel syndrome [IBS] specifically. I’ve been diagnosed with Binge Eating Disorder in the last five years and recently have been trying to solve my IBS with food changes through a naturopath and blood tests. Part of me feels like I’ve just fallen into another diet—and that my restrictions will lead to a binge—so I’ve been treading very carefully. I’m not sure where immunity and gut health fit into IBS and my symptoms. I’m having a hard time finding scientific backing!
—Cynthia