08/12/2026
Sometimes restrictive eating doesn’t begin with body-image concerns. It begins with, “My stomach hurts.”
That distinction matters.
A 2026 longitudinal study followed 6,228 early adolescents and found that gastrointestinal symptoms predicted greater disordered-eating symptoms one year later, including clinically significant disordered eating. The findings do not mean that GI symptoms cause eating disorders, but they do suggest that GI complaints may be an important early signal worth paying attention to.
At the same time, a growing body of research is documenting the overlap between gastrointestinal conditions and restrictive eating, particularly ARFID. GI symptoms can understandably lead a young person to eat less, eliminate foods, or become increasingly cautious about eating. In some cases, restriction can then contribute to additional GI symptoms and nutritional problems, creating a cycle that becomes increasingly difficult to untangle.
The clinical challenge is that both things can be true at once: a young person can have very real gastrointestinal symptoms and also be developing a pattern of restrictive eating that deserves attention.
What I would want parents and providers to notice is not simply whether a teen reports stomach pain, nausea, fullness, diarrhea, or other GI symptoms. It is whether those symptoms are beginning to shrink their relationship with food: fewer foods, smaller portions, skipped meals, increasing fear around eating, or difficulty meeting nutritional needs.
And because this type of restriction may have nothing to do with wanting to lose weight or change one’s body, it can be particularly easy to miss.
The goal is not to dismiss the stomach symptoms or assume they are “psychological.” It is to look at the whole picture early enough that both the GI symptoms and the eating changes receive appropriate care.
I put together this guide to highlight some of the signs that may warrant a closer look.
Research referenced:
Hamilton AL, Deyo AG, Kidwell KM. Somatic and gastrointestinal symptoms longitudinally predict early adolescent disordered eating. Journal of Pediatric Gastroenterology and Nutrition. 2026. doi:10.1002/jpn3.70474.
Berschback M, et al. Avoidant/restrictive food intake disorder in disorders of gut-brain interaction. Best Practice & Research Clinical Gastroenterology. 2025;79:102078.
Henriksen SB, et al. Avoidant-Restrictive Food Intake Disorder in Patients With Gastrointestinal Disorders: A Systematic Review. Journal of Human Nutrition and Dietetics. 2026.
