Digestive Issues – The Overlap of Anxiety and Eating Disorder Struggles

Contributor: Carrie A. Decker, Naturopathic physician

stockvault-fruit-collage138870Anxiety is an emotion that everyone is familiar with, and something we all experience on a day-to-day basis. Anxieties may focus on an issue at work, family or a relationship, health related concerns, or may have a generalized unknown focus. Anxiety around settings with food is an additional anxiety that is common in recovery from an eating disorder.

There may be anxiety about eating fear foods, eating the right thing, eating something that wasn’t a part of a meal plan, people watching you eat, or many other food related anxieties. Despite where you currently are at in your recovery there most likely has been a time when one or another of these was an issue.

And situational meal anxieties can arise for anyone, as these feelings may come up when meals involve a first date, a disagreement with a friend, or feeling rushed on a work day with an afternoon deadline.

The “Rest and Digest” State

For healthy digestion, our body must be in a “rest and digest” state. In physiologic terms this is called a parasympathetic state and is what happens when we are relaxed – our heart rate and breathing slows down, and our body isn’t ready to take action or run out the door.

When we consider digestion, the parasympathetic function is what promotes salivation, stomach acid production, pancreas secretion of enzymes, gallbladder ejection of bile, and regular motor function to move food through the small intestine and colon.

A parasympathetic state is even associated with the balance of flora (bacteria) in our intestines, and these bacteria serve to help digest our food, keep our intestines healthy, keep our immune system in balance, and so much more. So when anxiety comes along and leads to mealtime or chronic stress in the body, a lot of things start functioning less than optimally.

Natural Ways to Reduce Anxiety

DeathtoStock_Wired9There are many different natural ways to support the body in reducing anxiety and improving digestive system function. Starting at the top, it is important to plan time for our meals and to eat in a setting that is comfortable and without stress of computers or electronic devices.

Before meals, taking a moment to express gratitude for the food being prepared is important, whether this be internally or an expression of thanks or prayer. These things help to reduce anxiety and prepare the body for the consumption of food.

Smelling food is also important to start the digestive process of salivation! Remember the last time you smelled a garlic-filled Italian feast and how this triggered hunger even if you weren’t already hungry? Smelling a cut wedge of a lemon or lemon juice is another thing to stimulate this process.

Ways to Increase Digestive Function

Bitter herbs or foods have the effect of increasing digestive function. Herbal bitters that are specifically used to improve digestion are called digestive bitters. Digestive bitters not only support digestion at the level of the stomach, pancreas, and gallbladder, but by doing so often help with constipation as well!

Digestive bitters should be taken about 15 minutes before meals in a small amount of water. Other ways to include bitters in the diet also exist by using teas or by eating more bitter foods. Chamomile as a strongly brewed tea (or in an herbal extract called a tincture) is also a bitter, and is an important herb for supporting relaxation and calming digestive upset as well.

Bitter foods such as arugula, artichoke, or dandelion can be eaten in a salad at the start of a meal or with other foods. Digestive bitters should not be taken in high doses (follow package labeling if purchased) and should be used cautiously (lower doses) by individuals with heartburn or gastric reflux.

Digestive Enzymes

Digestive enzymes are an additional tool to help the body with indigestion. Digestive enzymes can be found in the majority of health food and larger grocery stores, and support problems of insufficient digestive secretions from the pancreas (and gallbladder if necessary).

A variety of different enzymes exist, including those that digest:

  • Protein (protease, bromelain, papain)
  • Carbohydrates (amylase)
  • Lactose (lactase)
  • Fats (lipase or bile)
  • The rigid structure of fruits and vegetables called cellulose (cellulase)

Beyond this specialty digestive enzymes can be found to help the body digest gluten, dairy, and beans or vegetables. Broad spectrum digestive enzyme supplements that contain support for digestion of all these things can be found, as well as enzymes focused on the specific items mentioned.

Herbs Used to Reduce Anxiety and Help Digestion

Helping hands, care for the elderly conceptA variety of herbs are useful for calming digestive upset, as well as reducing anxiety. Ginger and peppermint are herbs that help to reduce digestive spasm, with ginger being warming and helpful for nausea, while peppermint is cooling.

Fennel and chamomile are calming to the nervous system, and have a more gentle essence yet effective action of reducing digestive upset. Each of these herbs can be taken as a tea (or other form) to help reduce stomach cramping and pain.

Less specific acting but still helpful, probiotics and fermented foods are healing to the digestive system and support the reduction of anxiety. Probiotics and health gut flora have been shown to be connected with resilience under stress and decreased anxiety (1).

Reducing the Obstacles to Eating

Digestive problems are a negative feedback to healthy eating habits anyone is trying to engage in. It is difficult to want to eat when faced with heartburn, stomach aches, constipation, or diarrhea – not just for individuals with eating disorders but anyone!

For an individual in recovery from an eating disorder, the task of eating the foods we want to or know we should becomes more difficult and confusing when faced with digestive upset. Supporting the body in the process of healing by engaging in habits to reduce anxiety and promote healthy digestion is an important part of the treatment for every health condition, including that of eating disorders.

Naturopathic doctors spend with all of their patients to help them learn how to have better digestion and to reduce stress or anxiety if present. There are many natural tools that help restore the system back to balance, helping you to achieve better health and overall wellness.


  1. Foster JA, McVey Neufeld KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013 May;36(5):305-12.

Community Discussion – Share your thoughts here!

What steps do you recommend to improve anxiety and digestive health?

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on February 12th, 2015
Published on EatingDisorderHope.com