Avatar universal

Bloating? Diet? Disordered Eating?

Before I ask this question, I'd like to preface with some info. I've always struggled with my body image and getting a grip and accepting what I really see in the mirror. I have had a history of disordered eating and laxative abuse. I'm about 5'5" and weigh 134 lbs, just about average I think.

I've had constipation issues all my life, but also an emotional attachment to sweets. Certain foods do make me bloat and burp leaving me uncomfortable, which happens more often than not, but I don't have health insurance so I haven't been able to determine just what the issue is. I usually don't have bowel movements more than two to three times in a month.

Due to these issues, I suspect that some bloating has taken place. I also had gained about ten to twelve pounds a couple years ago, which spurred a period of disordered eating and laxative abuse (to both make myself go #2 and for alternate unhealthy reasons) in which I lost the weight within a month or two. Now laxatives don't work, prune juice doesn't work, eating more fiber doesn't work, and drinking more water doesn't work. The only thing that really makes me go is anxiety or when my period comes, which is irregular and can skip a month if it feels like it. I also recently dieted and cut out sweets for a week entirely, and not much changed regarding how I felt or my belly.

On top of this, I still struggle with eating disorder thoughts and obsessing over calories, and feel that everything I eat is too much (I don't usually go over 1300-1400 a day which I still feel like is so so so much) and it's all piling up on me day by day.

I look in the mirror and struggle with the fact that despite being average all around, all I see is a "pregnant" looking belly sticking out- not sagging or a pooch on my lower abdomen, but a literal 4 month looking pregnant belly that feels round and uncomfortable. (I promise I'm not actually pregnant lol)

The question I come to daily is, is this bloat or fat? It is on a daily basis, and feels smaller sometimes, but because of what I think might be body dysmorphia, all I see is fat.

I know that these are totally valid reasons to go and see a doctor and therapist, but again, I don't have health insurance at the moment due to just aging out of military benefits and having some issues trying to get Medicaid. I just would really like some perspective.
5 Responses
Sort by: Helpful Oldest Newest
Avatar universal
I have also that problem love to know the right answer
Helpful - 0
Avatar universal
I'd like to know what you mean by aging out of military benefits.  Since you mention Medicaid, are you currently unemployed?  Did you recently leave the military and are temporarily in between jobs?  I ask because I'm wondering if you were eligible for Tricare, and if so, why did you decide not to hold onto it, which I believe you can do.  Can you not afford the premiums?  This is some of the best health insurance you can have, and letting it go if you're eligible for it isn't a great decision, so again, I'm wondering what aging out of military benefits means?  My understanding, and I could be wrong as things could have changed, is once you have gov't insurance of any kind, including military, you can keep it forever as long as you pay your bills.  And again, you can't really get better insurance than gov't insurance.  If there's any way to keep it, do so.  That might mean talking to an insurance advisor in the gov't to see what your options are and if there's help when you can't afford premiums.  So there's that issue.  Second, I think your biggest problem is emotional, because it's what probably got you into this place to begin with absent some health problem such as is well discussed above.  Your abuse of laxatives probably caused the constipation and also makes it harder to get rid of it.  Medication is one of the biggest causes of constipation -- a lot of meds cause it and abuse of a lot of meds, including laxatives, can cause it as well.  Usually, it goes away when you stop the med or abuse of the med, but sometimes the body gets stubborn on us if we're unlucky and then we have created a long-term problem, which can be very hard and time consuming to fix and requires a big change in lifestyle, diet, and mental state.  Again, absent a physiological problem.  You don't say what you eat and you also don't mention exercise.  If you were in the military, I assume you exercised regularly.  If you got your military benefits as a spouse or some other way, then maybe not.  But exercise does keep things moving.  If you're sedentary, things get static, and if you've already caused your body to wonder what's going on with the abuse of your evacuation system being static will just make it even harder for your body to remember how it did things when things were working.  This doesn't happen to everyone, but it does happen, and it does no good for a person who gets a problem to know that most people don't get that problem.  Digestion problems are not an area docs are great at diagnosing or fixing unless it's something that really stands out.  Since you don't appear to feel able to see a doctor or therapist right now -- and you know, seeing a therapist is really expensive because you have to see them every week but it's not that expensive to see a doctor once.  But once they start ordering tests, the cost is beyond almost everyone if you don't have insurance.  That's why I would try to look at the parts of your life you can control on your own in the meantime, which is your diet, how much you exercise, and learning relaxation techniques to relieve stress and anxiety as much as you can while you figure out how to get treatment from a professional.  For example, if you eat a lot of red meat, stop.  It's really hard for the body to digest.  Legumes, nuts and seeds and fish can provide your protein needs and plant protein foods also contain fiber and is just easier for the body to break down without needing a lot of acidity to do so.  Now, legumes can also bring bloating and such, but there are so many of them there's usually some that don't bother us and ways to prepare them that makes them less likely to be a problem, and even though they might produce some of the well-known problems, they are good for going to the bathroom.  This is just one example of changes you can try among many that might just retrain your body how to go regularly if the problem was caused by that and not by some major physiological problem.  Also, imbalances in sexual hormones can cause problems as well, and you seem to be having those.  There are plant foods that also might help with that, and so can exercise if you don't exercise and relieving stress.  As for those folks with flat stomachs, most of them are very young, which doesn't seem to describe you, and a whole lot of them are taking steroids.  They won't tell you that, but take women sprinters -- a few years ago, they suddenly started looking like they had no bellies and had wonderful six packs and it turned out almost all of them were taking steroids.  It wasn't natural.  The women above are right, a natural belly isn't flat, because the best diet is mostly plant based and that will make it very hard to have a flat stomach.  We all want one, men and women, but almost none of us over the age of thirty have one even if we're not at all overweight.  This is new, by the way -- people didn't used to really care about this.  Anyway, I mainly wanted to add to already great advice above that it is very possible you did this to yourself and therefore can undo it to yourself, and to emphasize that if you can hold onto that gov't insurance, do so.  Peace.
Helpful - 0
And I should have added, I mention a lot of this because you're still abusing medication and are still obsessing over this.  The fact you went right back to laxatives shows that.  The fact you didn't just slightly alter your food intake and increase your exercise some for such an admittedly small problem shows that.  Counting calories doesn't actually work all that well as it's how well we metabolize and digest our food that really counts and you also admit you look pretty good overall and we can tell by looking at ourselves if we have a problem with weight or not.  We don't need a calorie count to tell us that.  So again, as you do what you need to do to get professional help, behavioral changes can start before that if you're willing and able to do that.  Peace.
Okay, forget one more thing.  Bloating if you actually have that and the other symptoms given you don't have a weight problem really are more a function most likely of what you're eating rather than how much.
649848 tn?1534633700
As Sarah noted, there are a lot of things that can cause the belly bulge, ranging from hormone imbalances to constipation.  

Even not eating enough can cause it.   The bloating and burping make me wonder if you could have H Pylori - that's a bacteria of the stomach that many of us have, but it doesn't cause trouble until it becomes a dominant bacteria.  I've had H Pylori twice and it causes a variety of symptoms, including constipation.  

As one who has had constipation issues for a good part of my life, I've learned that it's necessary to consistently make sure you eat adequate fiber, best in the form of vegetables, but whole grains also contain a lot of fiber.  When increasing fiber, we have to make sure we drink plenty of water because otherwise the fiber becomes "dry" and won't push on through.  It's also possible that, due to your constant constipation, the muscles of your intestines are malfunctioning so they can't contract and push the food through.  

You really do need to see a doctor to help you figure out the physical issue, but from dealing with a daughter with an eating disorder, I can tell you it's equally important to find someone to help with the mental health aspect so you can achieve/maintain a healthy body image.  You'll learn that our bodies change all the time, so a little tummy pudge isn't anything to worry about.  It's also normal to gain a bit tummy pudge as we get older.  A mental health professional can help you put everything in perspective.

Helpful - 0
Avatar universal
Lots of things can cause constipation, including laxative abuse.

But only having 2-3 bowel movements a month is definitely worrisome.

Short list of possible causes of constipation: not eating enough foods low in fiber, dehydration (not enough water, or electrolyte imbalance, which might be too much or too little electrolytes, not enough exercise (moving around can get our bowels moving around too), stress, eating too much milk or cheese, resisting the urge to have a BM, a bunch of medications, hormonal disorders (hypothyroidism, diabetes, hypercalcemia, and uremia), irritable bowel disorder, and many other medical conditions that affect the intestines.  

I'm not a medical professional, but I can talk from my own experience.  I very rarely experience any constipation (ever), but I also run everyday and assume that helps keep things moving.  The times I have had "a slowing of bowel movements" (so not every day, but still every other day) are times when I've been experiencing a lot of anxiety.  When I have high anxiety, I tend to eat a lot less food.  I don't count calories now, but most days, I'm around 2200-2800 (I run a lot, so 2800 is fine some days).  When I'm feeling so overwhelmed by anxiety, I eat much less (probably closer to 500-1000 calories a day), and that definitely slows my digestive tract down, because there is not enough food in my system to keep things moving forward, at least not quickly.  No one needs to run as much as I do, and I don't run in order to eat more food, I just like running, and I like to fuel my body with healthy foods because in order to keep functioning, it needs energy and nutrients.  If some days you are eating a lot less than 1300-1400 calories, there may be just not enough "stuff" in your digestive tract for things to move through.

My main concern for you with not going to a doctor is that if there is something physically wrong with your digestive tract or a hormonal issue, this can't be fixed by just trying to eat different foods or drinking more water.  I would strongly suggest you google "clinics for uninsured patients near me" and find out what it would take to see a doctor or nurse, even without insurance, at a cost you could afford.  I'm sure there are some on-line or tele-clinics for the uninsured that could help you both with your digestive problem and with mental health.

On to the question of whether it is belly fat or just bloating?  I have had thyroid issues for many, many years, and hypothyroidism can cause bloating/water retention and an increase in storage of fat specifically around the mid-section.  I'm currently at a healthy weight, but I've noticed I've put some fat on my belly and while the rest of me seems very fit, I carry a little extra weight specifically in my abdomen.  I've also just spent 5 months on medication that lowers my estrogen, putting me in a menopause like state, although I haven't hit real menopause yet.  Menopause, which is brought on by a drop in estrogen levels, causes many people to store fat in the abdomen instead of hips and thighs like they may have when they were younger and had high levels of estrogen.  That combined with skipping menstrual cycles might indicate a hormonal issue (PCOS and thyroid issues immediately spring to mind).  I'm not saying that you have either of those, but that might be something to rule out.  If you are storing extra abdominal fat, this means you have a higher risk of developing insulin resistance or metabolic syndrome, so if you do have higher levels of abdominal fat compared to other parts of your body, that is something that should be a concern.  (Not a reason to starve yourself though.)  

And, it may be what you think is "4 months pregnant" is actually "normal woman shape" and not an abdominal fat concern at all.  We are bombarded with images of women with 6-pack stomachs that our brains start to think that that is "normal" and "healthy" and that a slightly pudgy woman belly is "abnormal", when in fact, that is just a healthy belly, and to get to the "6-pack abs" on a woman, it usually involves dropping to low levels of body fat, which can disrupt or completely stop the menstrual cycle, and is not at all healthy for a woman to have that low body fat for an extended period of time (dangers include bone loss as well as the reduced fertility).

My best guess for you is if the "belly fat" goes away after you have a bowel movement (from anxiety/menstruation) or after your hormones drop (day 2-3ish of the start of a new menstrual cycle), it is probably not fat and just intestinal bulk or bloating.  If it stays after you clear out your system, then it might be fat.  If you are storing fat specifically in the belly area, I would strongly recommend getting your thyroid/other hormones checked out.  If you are not having regular periods, it would be a good idea to visit a gynecologist and make sure everything is ok.  People lose their periods for a variety of reasons.

You deserve to have a healthy body and proper medical care.   To get to that point, you may need to contact a doctor and work on both your eating disorder and also figure out if there are any underlying medical conditions causing constipation problems.  
Helpful - 0
134578 tn?1642048000
It could be fat and could be bloat; how old are you? If you're obsessive about weight that makes it sound like you're a teenager, but if you've aged out of military benefits, not so much. I'd say that the lack of pooping except twice a month, coupled with not many calories and a stomach that still sticks out, is abnormal enough to go to a doctor about, for sure, since you want to rule out something more serious than fat or bloat.
Helpful - 0
Plenty of people older (and younger) than teenagers are obsessive about their weight.  I know people who became obsessive about their weight after having kids, in their 30s.  Eating disorders and worrying about your weight does not have an age cut off.


Age of Onset
Based on diagnostic interview data from the National Comorbidity Survey Replication (NCS-R), median age of onset was 21 years-old for binge eating disorder and 18 years-old for both bulimia nervosa and anorexia nervosa.

If that link shows up, it has several charts showing how prevalent different eating disorders are in adults (different age groups) and adolescents.  It looks like it is more "prevalent" / a higher percentage of adolescents have eating disorders, but according to Figure 1, more 45-59 year olds have binge-eating disorders compared to 18-29 year olds.

(I'm just trying to say that the original posted does not sounds like a teenager to me, just someone who struggles with food, food decisions, thoughts about her body, and worrying about her weight, just like many people of different ages.)
By mentioning the fact that teens often obsess with body image, I was merely trying to politely ask the o.p. her age without coming out and bluntly asking. This is because she asked for "perspective," and it's hard to offer a valid perspective if it's not clear now long she has had she's had an obsessive approach to food. It's never easy to straighten up disordered eating habits, but it's harder to break away from the mindset and the habits if they have been with you for years. I agree it doesn't sound like she's a teenager. How many years this has been going on seems like it might be pertinent to the discussion.

Another question it might be helpful to know is whether the o.p. has ever been pregnant. Though relatively slim all my life, my abdomen sticks out more now that I've had a child, and I think it won't ever be quite the same as before no matter how much or little I weigh. If the o.p. is worried about something that naturally happens due to having carried a baby nine months, it might help her to know that this is pretty common.

Also, the o.p. has ruled out going to a doctor (probably no matter what we say). My perspective is that it doesn't matter if it's fat or bloat as much as it would matter if it's cancer.  Advising her to see a doctor when she has already said she won't see one might be a fool's errand, which is why I left my advice so short. (Incidentally, I thought all of your advice was useful, sympathetic and helpful, and I hope she takes it seriously and thinks over everything you said.) If she does go to a doc and finds this all is merely the result of her eating disorders, she will still have obsessions about food to deal with, but at least she will have ruled out something more serious.
Hi Annie,

Sorry, I didn't meant to offend you, and I can see your reasoning behind what you said.  I wasn't trying to be dismissive of your advice but to make her feel more included by mentioning that not just teenagers suffer from eating disorders, since there is sometimes a stigma against adults having problems that we usually think of as a "teenager" problem, and maybe it did not come across the way I intended it.  I'm very sorry.

As for not seeing a doctor, she mentioned having issues trying to get Medicaid.  That's different than refusing to see a doctor, implying that she would see a doctor if she did have Medicaid coverage, or if she still had coverage through the Tricare/the military.  Sometimes it is hard when we don't know what options are available to us, we can feel frustrated and lost.

I still stand by my recommendation of looking in to ways to see a doctor, even without insurance.  There is a website freeclinics.com which allows you to look up your state, and look for free or income based clinics in your area.  One problem may be the original poster lives in a more rural area that does not have free clinics anywhere near her.  I live in Ohio, and using the website, I found 11 free and income based clinics in my area.  So... if it is taking awhile to get Medicaid coverage, or if there is a problem and that isn't even possible, and she feels like something is medically wrong, this could be an option.  There is nothing wrong with seeking medical attention for a health issue, even if you don't have insurance.  There are options.

And, let's say she never wants to get medical attention for what might just be bloating and constipation (which I completely understand, I went a long time without seeing a doctor when I was younger).  This could be an option for her if she has medical issues in the future that need immediate attention.  I just wanted to put it out there as an option.  

Sarah, I was not offended, and agree that sensitivity is called for when discussing eating disorders, lest one imply to an adult woman that it's a teenage problem.
Have an Answer?

You are reading content posted in the Weight Loss and Fitness Community

Top Healthy Living Answerers
649848 tn?1534633700
Avatar universal
Arlington, VA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
14 super-healthy foods that are worth the hype
Small changes make a big impact with these easy ways to cut hundreds of calories a day.
Forget the fountain of youth – try flossing instead! Here are 11 surprising ways to live longer.
From STD tests to mammograms, find out which screening tests you need - and when to get them.
Tips and moves to ease backaches
Here are 12 simple – and fun! – ways to boost your brainpower.