Natasha's Story: Eating Disorders and the Microbiome

natasha

Hi, I’m Natasha.

One of the first things the doctor said to me when I was first diagnosed with an eating disorder was that by going down this path, I’m basically committing a very slow suicide. Calmly, she explained that as the eating disorder progresses, the brain will shrink and my cognitive functions will decline. The body will begin to reclaim muscle non-selectively to try and obtain the protein and other nutrients it’s not receiving through diet – potentially leading to problems and/or failure of the heart or other organs. The stomach will shrink, and the digestive system will atrophy, since it’s not being fed, and therefore can’t properly carry out its activities.

Through experience, I also learned that the idea of food becomes difficult to stomach, relationships decay, and life in general becomes very difficult to cope with.

These symptoms sound terrifying – and they are. For anyone else, this would be more than enough motivation to do anything that would allow them to recover as soon as possible. For the most part this means drastically increasing food intake. And who wouldn’t want an excuse to eat more? Or be encouraged to eat whatever they want and as much as they want so that they can get back to a healthy weight?

For someone with an eating disorder, the prospect of eating and putting on even a few hundred grams is more terrifying than all of these things.

After a while, the process of eating becomes not only psychologically uncomfortable, but also physically painful, frequently leading to bloating, gas, constipation, and sometimes nausea.

A few months after I was diagnosed, I was due to start university at the age of 16. What was already to be a huge transition was made more difficult, as I was undergoing treatment. I began to blog about my experiences, more as a way of helping myself cope with it all, and to explain to those around me what it was like – since it was often confronting for them. I soon found that people started to approach me, and tell me that they were experiencing similar things. What scared me here was the state of their wellbeing, and how common it was. I certainly didn’t wish what I was feeling on anyone else.

At this stage, I was also developing an interest in molecular and microbiology, and by my second semester I had transferred to another university to pursue this. It wasn’t until my second year that I got to take my first microbiology course. While I was excited about everything I was going to learn, I never expected it to be more than an academic interest. I was lucky enough to have an incredible lecturer that pushed us to work hard and develop problem solving skills – and while normally I’d be overwhelmed by this, my increasing love of microbiology made me more determined to get through it. With this determination came the small but powerful push to try to get better, and the confidence to do things I was too afraid to do otherwise. While I still haven’t put on the weight, it at least encouraged me to eat enough to function at the level required – which was a big step.

This wasn’t the only benefit though. Because I was so keen to learn about microbiology, I started reading everything I could about it, and trying to stay up to date with new developments. Just over a year ago, the word “microbiome” started to pop up everywhere, and all of the sudden people were learning that the bacteria on, around, and in our bodies play a much larger role than previously thought. Studies into how it (particularly the microbiome of the gut) affects mood, depression, obesity, immunity, and many other aspects of health were being conducted. This led me to start asking about the effects of eating disorders on the microbiome, how this in turn affected the body, and how it could possibly lead to something that could help people suffering from eating disorders.

Recently, uBiome announced that they are collaborating with Dr. Cynthia M. Bulik at the University of North Carolina Centre of Excellence for Eating Disorders to attempt to answer some of these questions.

The gut microbiome has been shown to have significant impacts on the functioning of digestion, the immune system, and many other functions of the body. An imbalance of the microbiome can contribute to many diseases, and can allow selection for bacteria such as C. difficile – a bacterium commonly found in the gut which in high numbers is associated with ulcerative colitis. Bacteria deprived of nutrients can also begin to eat into the gut lining, and cause inflammation and problems in the gut – decreasing the ability to digest food properly and absorb nutrients.

This makes people with eating disorders particularly susceptible, since their food intake is insufficient to sustain their microbiome (not to mention themselves). Lack of nutrients taken in would drastically decrease both the diversity and abundance of microbes in the gut – sometimes permanently – and as described above, this can have serious consequences.

Studies into the role the gut microbiome plays in eating disorders and vice versa are therefore incredibly important and may lead to discoveries about what influences the development of eating disorders, likelihood of relapse, and insights into how to make the re-feeding process more comfortable. While it’s only early, and will likely take several studies to fully understand the relationship between eating disorders and the gut microbiome, this is a significant first step in the process, and one which will hopefully lead to new ways of helping to treat, or even cure them.