5 Reasons I might not recommend an elimination diet.

1. The psychological risks outweigh the potential benefits of the elimination diet, particularly for those with a history of or current ED.

2. There are signs of malnutrition or you already aren't able to meet your nutrition requirements.

3. Your symptom pattern indicates a food intolerance is unlikely.

4. Practical or financial barriers are significant enough that the diet would be either unrealistic or detrimental to your quality of life.

5. There are simpler, safer, or possibly more effective strategies for us to try to improve your symptoms.

Most “tools of the trade” in healthcare come with pros and cons, or benefits and risks.

Medications

Procedures

Exercises

Equipment

Therapies….

and health practitioners (should) conduct thorough assessments to determine suitability for any intervention.

Elimination diets are no different. Elimination diets are protocol-driven, therapeutic diet modifications with the aim of improving symptoms or management of a health condition, and on balance of all factors, should result in an overall improvement in quality of life.

That last part is important and should be reflected on regularly with any dietary protocol or recommendation.

I probably spend more time de-prescribing and liberalising elimination diets than I do commencing them, despite being quite comfortable guiding elimination diet protocols when clinically necessary. This is usually for one of the 5 reasons I describe here.

These reasons aren’t static. They change for people at different stages of their condition and circumstances. However they should always be thoroughly assessed, with contingencies and plans in place to manage any potential risks as required, before commencing an elimination diet.