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You can support healing autoimmunity through diet and nutrition. However, many healing diets are restrictive requiring the removal of foods that exacerbate autoimmune symptoms and replacing them with foods that nourish at a cellular level. This kind of diet can be a new and often challenging way of eating.

One such diet is the autoimmune protocol (AIP diet). This diet can be a tool for helping people manage autoimmune disorders like Hashimoto's thyroiditis. The AIP diet is a temporary elimination diet designed to help heal the body. However, there is growing concern that elimination diets may cause certain people to develop unhealthy food relationships. This concern is especially true for people with a history of disordered eating.‚

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The AIP diet stands for autoimmune protocol diet. It is a two-phase temporary diet based on the paleo diet. It serves as a tool for people with autoimmune diseases to identify foods that exacerbate their autoimmune conditions. The AIP diet may be helpful for people with conditions like:

• Hashimoto's disease
• Graves' disease
• Lupus
• Rheumatoid arthritis
• Crohn's disease
• Irritable bowel disease
• Celiac disease
• Psoriasis

You can tailor the AIP diet to meet your individual needs. Still, it is guided by two distinct phases: an elimination phase and a re-introduction phase.

The elimination phase eliminates all foods that may be a source of inflammation, such as foods high in sugars, gluten, or toxins like alcohol. 

Examples of common trigger foods removed during this phase include gluten and grains, sugar, dairy, eggs, legumes, nightshade vegetables, and nuts and seeds. These foods show a correlation with causing a microbial imbalance in the gut and aggravating chronic inflammation and pain. This phase lasts as long as it takes to see some improvement in your symptoms, generally about six weeks.

After the elimination phase, you start slowly reintroducing foods, one group at a time. It is best to reintroduce slowly and intentionally so you can assess for any symptoms and correctly identify which food is a trigger. 

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The AIP diet restricts certain foods, so people with a history of an eating disorder may have difficulty navigating this diet without support. We know that dieting, in general, is a risk factor for developing an eating disorder. That risk can increase the more severe the restriction. 

Disordered eating may include restrictive eating, compulsive eating, or irregular or inflexible eating patterns. Dieting is one of the most common patterns of disordered eating.

Other behaviors of disordered eating may include:

• Fasting
• Binge eating
• Skipping meals
• Obsessively avoiding a type of food or food group
• Self-induced vomiting
• Laxative, diuretic, enema misuse
• Steroid and creatine use
• Using diet pills

It's worth noting that the intention of the autoimmune protocol (AIP diet) is not to restrict your calorie intake. Instead, the purpose is to replace common dietary triggers with enough nutritious, healing foods to still satisfy your caloric requirements and reduce thyroid-related symptoms.

Still, completing the autoimmune protocol (AIP diet) requires intense attention and focus on your diet. For some people, this can lead to obsession and desire for perfectionism, leading to eating disorders like bulimia nervosa, anorexia nervosa, and orthorexia.  

Orthorexia is a condition characterized by a problematic fixation on eating healthy food. Healthy eating may not seem like a bad thing. Still, it can become problematic if you start to have compulsive behavior, feel low when you violate your dietary rules, increase your restrictions, or even develop malnourishment. 

Orthorexia is not a formally recognized eating disorder in the Diagnostic and Statistical Manual (DSM), the primary resource for all psychological conditions. However, more and more people seem to fall under this category of disordered eating.

Additionally, when people find that restricting certain foods makes them feel better, they assume that more restrictions will more greatly improve how they feel. While feeling better through dietary management is the goal, it can lead to this assumption that more is better when restricting food. This mindset can lead to unhealthy relationships with food. It can even cause people without a history of disordered eating to have a poor relationship with eating. 

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Restricting the amount of food you eat can be dangerous. When your body does not get enough food, it reduces the rate of burning energy (the metabolic rate). This results in overeating or binge eating behaviors, traping you in the diet cycle.

Restricting the amount of food that you eat causes the metabolism to slow down, but appetite and cravings to increase. More often than not, these restrictive rules are broken, leaving you feeling guilt, low self-esteem, or negative body image. With these feelings comes a resolve to "do better," and the diet cycle begins again.

Disordered eating can also negatively impact a person's mental health and reduce your ability to cope with stressful situations. Relatedly, a person with disordered eating behaviors may avoid socializing in situations where people will be eating, contributing to low self-esteem or social withdrawal.

Determining if you have an eating disorder is challenging and usually requires a professional to help you diagnose and treat. The National Eating Disorders Association (NEDA) considers the following risk factors for eating disorders:

• History of an eating disorder
• Having a close relative with an eating disorder or mental health condition
• History of dieting
• A negative energy balance, where you burn more calories than you consume
• Having type 1 diabetes, especially if you are female
• Being a perfectionist
• Dissatisfaction with your body image
• Weight stigma
• A history of being teased or bullied
• Believing there is one perfect body type
• Acculturation
• Having a limited support network
• History of trauma

All of these criteria may predispose you to develop an eating disorder. However, you also may notice your relationship with food is becoming unhealthy if you:

• Notice diet, weight loss, and controlling your food intake become your primary focus
• Become preoccupied with counting calories, checking your weight, and breaking down nutrient contents in each meal
• Have food rituals
• Limit your portions or skip meals altogether
• Feel uncomfortable eating with others
• Are overly focused on body size and shape
• Have extreme mood swings

Anyone considering the AIP diet should approach this diet as a tool for helping them gain better control over their autoimmune disorders. It serves to reduce food toxins from leaking into the bloodstream and aims to help you heal.

To be sure, the AIP diet is not the only dietary modification available for supporting thyroid health. We recommend that anyone with a history of a severe eating disorder like bulimia or anorexia work with a trained health care professional to help them navigate all diet phases. 

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The AIP diet does not need to be a one-size-fits-all diet. You can tailor the diet based on your unique needs and history.

Suppose you have a more general history of eating disorders like frequent dieting or orthorexia. In that case, it may still be beneficial to work with a nutritionist. Together you can set achievable, realistic goals so that you do not overly restrict yourself.

No person should be more food-restricted than necessary. Each of us is unique with individual sensitivities. If you have an autoimmune thyroid condition like Hashimoto's thyroiditis, meet with a thyroid nutritionist to develop a nutrition plan customized to fit your specific needs. 

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A note from Paloma Health

If you experience disordered eating, please seek help. Disordered eating is the principal risk factors for developing an eating disorder. Seeking help early is the best preventative step. Your primary care physician is an excellent place to start. 

It's possible to change your eating behavior, even if you've experienced disordered eating for a long time. With the proper support and treatment, behavior change is possible.