Is Your Gut Influencing How You Feel About Your Body?

Is Your Gut Influencing How You Feel About Your Body? A New Perspective on Anorexia Nervosa

We’ve long understood anorexia nervosa as a psychiatric disorder, driven by distorted thinking, fear of weight gain, and emotional pain. But what if part of the problem isn’t just in the mind… but in the gut?

Recent research is opening up a fascinating and complex new perspective: that our gut microbiome, the trillions of bacteria and microbes living in our intestines, might play an unexpected role in both the onset and maintenance of eating disorders, including anorexia nervosa (AN). While still an emerging field, the evidence is growing. Here's what you need to know.

The Gut-Brain Axis: A Two-Way Communication System

The connection between gut and brain isn’t metaphorical; it’s biological. Known as the gut-brain axis, this intricate communication system involves the vagus nerve, hormones, neurotransmitters, and immune responses. It allows your digestive system to send and receive messages to and from the brain constantly.

This system doesn’t just regulate digestion, it plays a key role in mood, decision-making, and self-perception. Your microbiome influences serotonin production (around 90% of serotonin is produced in the gut) and can shape how you respond to stress, anxiety, and even food.

Gut Dysbiosis in Anorexia: What the Research Shows

An increasing number of studies are identifying microbiome imbalances in people with anorexia. A 2024 study published in Nature Microbiology revealed several distinctive patterns:

• Loss of diversity in key bacterial species like Clostridium, which are involved in metabolism.

• Increased presence of bacteriophages, viruses that attack bacteria and further disrupt microbial balance.

• Reduced production of nutrients like thiamine (vitamin B1), essential for nervous system function and energy metabolism.

These findings suggest that in Anorexia, factors in the gut environment not only alter but also actively sustain disordered eating patterns.

Could Gut Bacteria Influence Self-Perception?

Here’s where things get particularly interesting: emerging data suggests that gut microbes may influence interoception—our internal sense of bodily states. Altered interoception impacts the accuracy of our perception of hunger, fullness, and even physical form.

In individuals with AN, this internal "body reading" appears to be significantly impaired. And while we can’t yet claim that bacteria cause distorted body image, we do know they influence neurotransmitters (like serotonin and dopamine) that shape emotional processing and self-awareness.

Starvation Alters the Microbiome—But It Might Also Start There

I first thought about how the gut might be affecting eating disorders back in 2017 after reading a very influential book Gut: by Giulia Enders. Later, clients suffering from phagophobia told me that their healthcare providers had diagnosed them with anorexia when, in fact, it was phagophobia. They were dying to eat a meal.

Anorexia causes significant nutritional deficiencies, which reshape the gut microbiome. But some researchers argue the gut might not just be a passive victim of starvation. It could be a contributor. In this view, a pre-existing imbalance in gut bacteria may predispose some individuals to restrictive eating by affecting appetite signals, anxiety levels, and mood regulation.

This creates a harmful feedback loop: malnutrition worsens the microbiome, and the disrupted microbiome then reinforces the psychological and physiological patterns of the disorder.

Chemical Signals That Suppress Appetite

Some molecules produced by gut microbes actively interfere with normal appetite regulation:

• Indole-3-propionic acid may reduce hunger signalling.

• Secondary bile acids can disrupt hormones like leptin, which normally tells us when we’re full.

• Tryptophan shunting by bacteria can reduce the availability of serotonin precursors, affecting both mood and satiety.

These aren’t just abstract biochemical processes - they directly affect how you feel, what you crave, and how your body regulates eating.

Experimental Evidence from Mouse Models

In a 2023 landmark study, researchers transplanted gut bacteria from people with anorexia into germ-free mice. The results were striking: these mice ate less, gained less weight, and showed changes in their brain genes related to appetite suppression.

It’s one of the strongest indications yet that microbiota can influence behaviour, specifically, behaviour related to food intake and body energy use. While mice aren’t humans, the findings support the idea that gut microbes can play an active role in shaping anorexic behaviours.

Exploring the Role of Perfectionism and Self-Criticism

Interestingly, some of the microbial patterns found in people with AN have also been linked to personality traits like perfectionism, anxiety, and obsessive thinking. This doesn’t mean the bacteria cause these traits—but it does point to the potential for gut imbalances to influence mental health patterns often seen in AN.

This is especially relevant for professional women juggling high expectations, tight schedules, and often internalised standards of success, including physical appearance.

Innovative Therapies: Treating the Gut to Support the Mind

As understanding of the gut-brain connection grows, so do treatment possibilities. Some promising areas of research include:

• Probiotics, particularly strains like Lactobacillus plantarum, which may support healthy weight restoration and reduce anxiety.

• Faecal microbiota transplantation (FMT), currently in early trials, which aims to reset the gut environment by introducing a healthy microbiome from a donor.

• Targeted supplementation, such as vitamin B1, omega-3s, and prebiotics, to nourish the gut and support microbial diversity.

These treatments are still in the experimental phase, but they offer hope for more holistic approaches to recovery.
Talking therapies such as Human Givens and Solution-focused hypnotherapy can help support and build confidence to make the changes needed.

What This Means for You

If you’re navigating recovery from anorexia, struggling with body image, or simply interested in understanding your own health more deeply - this research matters. It validates the idea that healing must be multifaceted, addressing not just the mind, but the body’s internal ecosystems as well.

You can start supporting your gut-brain axis today by:

• Eating a diverse, plant-rich diet to feed beneficial microbes

• Managing stress through hypnotherapy, mindfulness or meditation

• Avoiding unnecessary antibiotics, which can disrupt microbial balance

• Keeping track of how dietary changes affect your mood and body perception

Above all, it’s important to seek support. Nutritional psychiatry, gut-brain research, and integrative therapies are developing fast. Stress is a large factor in how we deal with problems with eating difficulties, which is why finding the right type of talking therapy as a support is vital.

Final Thoughts: A More Compassionate Lens on Anorexia

We often view anorexia as purely a psychological disorder, but science is urging us to take a more compassionate and biologically informed view. The microbiome may not be the root cause, but it’s likely a powerful contributor to the vicious cycles of restriction, dysmorphia, and emotional distress.

For women in their 30s, balancing career, relationships, and identity, it’s empowering to know that supporting your gut health might also support your self-image, mood, and resilience.

As research evolves, integrating microbiome science into mental health treatment could revolutionise how we approach anorexia and other complex disorders. The body and brain are not separate, and healing one means paying attention to both.

#Phagophobia #Anorexia #Pseudodysphagia