Mia’s story: How I tried an elimination diet - and ended up bulimic
Open a newspaper, and you’re almost guaranteed to stumble upon news of the latest faddy diet. Whether it’s the Sirt food diet, GAPS, Paleo or going sugar-free, it seems we’re constantly bombarded with information about what we should and shouldn’t be putting in our mouths.
Headlines scream about diets, which will change your health - and weight - forever. More often than not, we are told we can achieve our dream bodies by sticking to rigid programmes which all seem to have one thing in common: elimination. Gluten, dairy, sugar, carbohydrates, meat: they’ve all been branded as ingredients we should be avoiding if we want to keep the weight off.
Just this month, a newspaper produced yet another report on a diet trend. This time, it centred on FODMAP, a little-known diet designed to help people with digestive disorders including Irritable Bowel Syndrome and Crohn’s.
It’s a diet I know well. And it’s one, like so many diets promoting elimination, which I believe should be avoided at all costs.
I started the FODMAP diet almost two years ago after being diagnosed with Irritable Bowel Syndrome (IBS). After months of bloating, diarrhoea, constipation, pain and low energy, I desperately went online to find out what I could do to help myself.
Within minutes I came across the FODMAP diet. It promised to cure IBS by avoiding any food that might trigger symptoms, including gluten, lactose, blackberries, asparagus, onion, garlic, mango, apple, nectarine, plum, dates, prunes, camomile tea, cherries, avocado, too many nuts, too much fruit at once, cream cheese, broccoli, honey and chai. The list was endless.
I was daunted, but I felt reassured that it was promoted on the NHS website. For the first six weeks, I followed the diet down to the letter. Miraculously, my IBS symptoms all but disappeared.
But at the same time, I dropped six kilos to become almost underweight. With so many ingredients eliminated, I was barely eating. My friends commented on how ‘tiny’ I looked and my mum admitted she was worried about me. But I liked the attention: I could wear clothes I had never felt comfortable in before and felt more confident than I had in a long time.
Then, a new role at work meant I was working long hours and could no longer control everything I ate. I suddenly found myself unable to keep up with FODMAP. I can only describe that moment as a terrifying loss of control that would plunge me into total chaos.
Suddenly, food became my worst enemy and I began to have panic attacks at meal times. Eating out was a nightmare and going to dinner parties filled me with dread. At the same time, I felt like my body was beyond my control, getting fatter by the day as I inevitably regained the weight I had lost so quickly.
My relationship with food was destroyed. I was convinced that all the ingredients on FODMAP’s list would poison me and make me ill. That was only confirmed in my mind by the fact that I suddenly seemed to react to everything I ate. I was constantly tired and bloated. I woke up every morning with a sharp pain in my stomach, which only relented when I went to sleep.
One day, after a particularly big meal, I felt awful: bloated, fat, full of forbidden FODMAPs. I felt anxious, like I had to get that food out of me. For the first time in my life, I went to the toilet and made myself sick.
It felt as miraculous as FODMAP had: the pain in my tummy practically evaporated and I felt happy none of the food I had just eaten could harm me. Soon purging became a regular habit, serving a double purpose: eliminating FODMAP ingredients and calories in one easy step.
For months, I persuaded myself that I was purging to help my IBS. I was quite literally eliminating the ingredients FODMAP had banned. It was easier this way: I was no longer a nuisance at dinner parties or in restaurants and I could control what I was eating.
Meanwhile, my preoccupation with my weight began to consume me. I woke up to a voice bullying me into hating myself. The only escape from it would be going to sleep. I started taking sleeping pills at one point to turn it off and get a full night’s sleep. But I felt like I was going mad. I stared at myself obsessively in front of the mirror, focusing on my thighs, then my stomach, then my arms, then my back.
Then, I went on holiday and made myself sick every day. It was my personal rock bottom. On the last night, I sat in bed in tears, exhausted from my behaviour and from the torment in my mind. It was finally dawning on me that I wasn’t well. I tentatively looked up bulimia and slowly everything fell into place.
I sought help immediately and began working with Mary Wood at Foundations UK. Through weekly therapy sessions, Mary helped me to understand that FODMAP had severely damaged my relationship with food, even using the word ‘trauma’ to describe the effect it had had on my eating.
But Mary also made me understand that I was using food and bulimia as a way to detract from what I was feeling. I was swimming in anxiety after a horrible break up. My self-esteem was almost non-existent after floundering in a job I hated.
I had never made the connection, but my tummy trouble had started just as stress had really begun to affect me, first during a gruelling Masters course then in a job I wasn't enjoying. In both scenarios, I was constantly questioning if I was good enough and felt like I was only just keeping up with the work.
The main cause of my IBS, it turned out, had never been food: it was stress. And when people with IBS are statistically more likely to suffer from anxiety and depression, why had no GP, no dietitian, ever asked me about my stress levels or if I was feeling anxious? Guiding patients with depressive tendencies to a restrictive diet that has the potential to be so dangerous, instead of offering psychological help, seems to me a toxic idea.
After months of therapy I am now bulimia free. And, most importantly, I have now learned how to control my anxiety, which has, in turn, cured my IBS.
But I feel compelled to share my story for a number of reasons.
I want anyone else suffering from IBS to know that FODMAP is not the only option and for them to understand the dangers of the diet if they do decide to embark on it.
I want all elimination diets to be approached with care and understanding of what sort of impact they can have on a person’s eating. I have seen articles promoting FODMAP as a miracle diet for a flat stomach in the national media, which I feel incredibly wary about.
My experience has taught me that our relationship with food can be very fraught. Now, I want it to be known that disordered eating is not a result of vanity or wanting to look good. I want people to know that when a person’s relationship with food breaks down, either in anorexia, bulimia, overeating or even obesity, it’s because food becomes a means of coping with emotional difficulties. It is not about being greedy or vain. I want us never to look at an obese person and think that they are simply unable to control their appetites. I want us to understand these disorders need psychological treatment rather than simply telling obese patients to 'eat less, move more' as it so often the case.
For those suffering with such complex problems, there is no quick fix. That is why we need the help of charities like Foundations UK, to ensure patients suffering a disordered relationship with food can get the help and education they need to get their live back on track, just like I did.