Intermittent Fasting and Eating Disorders: Can They Coexist?

Intermittent fasting (IF) is all the rage at the moment. There are several types of IF, and people see results. But is there a danger in the practice of fasting, especially if you are diagnosed with an eating disorder? What about intermittent fasting if you typically engage in binge-eating behavior?

It’s important to first identify the three common eating disorders (ED) and then explain the pros and cons of intermittent fasting.

What is considered an eating disorder?

An eating disorder (ED) is not a diet someone has taken to the extreme. It is a mental condition that revolves around obsessive thoughts about food. It might be starving oneself to remain thin, purging food out of the system as quickly as possible, or eating tremendous quantities of food in a short time frame.

As many as nine percent of the American population will experience an eating disorder during their lifetime, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD). Eating disorders are among the deadliest mental conditions to date, with more than 10,200 people in the United States losing their lives from ED complications each year.

There are three common eating disorders: anorexia nervosa, bulimia, and binge-eating.

Anorexia Nervosa

Anorexia is the preoccupation with one’s appearance and the intake of food. Anorexic individuals may feel disgusted with their bodies or with food. They may attempt to starve themselves for control. Like with other eating disorders, choosing when and what to eat is a form of control. Some people use this to give themselves a sense of security when their lives feel out of control.

The person with anorexia will become a skeleton of their former self, weak, severely underweight, and unhealthy. Without enough nutrients, the body loses fat, muscle, and bone mass. Organ systems will eventually fail, and the heart will stop functioning. This behavior, if left untreated, is fatal. Not only from the inevitable shutdown of the body’s systems, but also the suicide rate for people with eating disorders is high, at around 26%.

Bulimia

While those with anorexia avoid food or eat very little, people with bulimia may consume food normally or in smaller amounts but obsess about ridding the body of the calories as soon as possible. These purging methods can include self-induced vomiting, laxatives, enemas, or extreme exercise. Just as dangerous as anorexia, bulimia destroys the digestive system, the esophagus, teeth, colon, and other systems from the constant purging behavior.

A bulimic may be at their average weight or underweight. With any eating disorder, mood and mental health are also affected. Depression, anxiety, and fear are prevalent. When the body lacks nutrients, the brain does not have enough fuel to operate, and thinking becomes cloudy. As with anorexia, if left untreated, bulimics may need intravenous feeding tubes and oxygen to save them from death.

Binge-eating

Binge-eaters indulge in behavior as if trying to fill a void in their life and in their hearts. A binge-eater may be overweight or obese. Although a binge-eater might plan the binge, they often consume large amounts of food mindlessly in a short period of time. They may eat late at night after their family goes to bed or stop on the way home at a fast-food place to eat hurriedly in their car and dispose of the evidence before they reach home.

While bingeing, the person may not feel the full sensation from their stomach as it stretches. Once the stomach begins to reach fullness in typical eating situations, the brain signals to slow down and stop eating. Food will lose its taste when the stomach is approaching its appropriate limit.

However, during a binge, those signals get lost. The binge-eater can consume thousands of calories and still not feel full. When the binge is over, the person will feel physically and emotionally sick and drained.

This behavior is also physically demanding, with extra fat stores, high blood pressure, high cholesterol levels, and heart attack or stroke risk. Depression, anxiety, guilt, and shame can weigh just as heavily.

What is intermittent fasting?

Intermittent fasting is a break from food to give the digestive system relief. The most common fasting practice is after dinner until breakfast (breakfast = break the fast). For some people, this could mean an eight-hour break. For others, it can mean twelve hours, depending on what time you finish dinner and if you do not have a snack before bed.

Studies show that intermittent fasting can greatly affect insulin resistance, blood sugar levels, cholesterol levels, blood pressure, and fat loss.

The most common intermittent fasting plans are 16:8, 20:4, 5:2, and alternate-day fasting.

With the 16:8 plan, the person fasts for 16 hours and eats meals in an eight-hour window. With the 20:4 plan, the fasting window is expanded to 20 hours, and the eating window shortens to four hours.

In the 5:2 plan, the person typically eats five days a week, then cuts back on the amount of food they consume two days a week (generally non-consecutive days). They might fast from food completely with only water or calorie-free drinks or limit their calorie count to a low number.

However, there are some drawbacks to intermittent fasting. Without regular food consumption, the blood sugar level can decrease, causing lightheadedness and moodiness. Many people begin to feel tired during the fast or extremely hungry, especially in the beginning as the change in eating shocks the body.

These are just a few of the IF plans that people use. But should you practice IF if you have been diagnosed with an eating disorder?

Should you practice IF if you have been diagnosed with an eating disorder?

Although intermittent fasting boasts impressive results both medically and with weight loss, practicing IF while dealing with an eating disorder can be devastating. People who suffer from anorexia nervosa need to learn to eat regularly. Depending on the severity of the mental condition, this lack of food (or controlling the fast window) can lead to a downward spiral.

Bulimics tend to fast intermittently, whether they realize it or not, as part of the purging process. They might eat a larger meal, then willfully starve themselves to purge or lessen the “damage” done by the food. The psychological aspect of controlling the timing and food portions is just as strong with IF as with bulimia. If you are diagnosed with bulimia, you should avoid intermittent fasting and speak with a therapist about a treatment plan.

Binge-eaters might be able to intermittently fast, but only under the supervision of a medical professional. It depends on the severity of the condition. Going long periods without eating will lead to a drop in blood sugar and increase irritability.

Some binge-eaters will actually binge once the fast ends. The binge raises the blood sugar (albeit probably much higher than is needed) and provides momentary happiness and relief. Unfortunately, this results in the binge-eater being caught in the vicious cycle again.

A medical professional specializing in nutrition and eating disorders can steer you in the right direction for a treatment plan, not only for your body but also for the mind. You should avoid fasting until you have been given the all-clear from your physician. It may derail your progress.

You should never engage in any extreme eating regimen until you have spoken to your physician and nutritionist. If you have been diagnosed with an eating disorder, consult your therapist. Intermittent fasting does have its benefits, but if it hinders your progress or robs you of your peace, then it is certainly not worth it.

If you do not already have a counselor, contact our offices today. We would love to help you and pray for you as you seek treatment and manage your relationship with food. Appointments are available with the therapists in our practice who have experience with eating disorders.