Exploring assemblages of irritable bowel syndrome, dietary practices and disordered eating / eating disorders : a thesis presented in partial fulfilment of the requirements of the degree of Doctor of Philosophy in Health Psychology at Massey University, Albany, New Zealand

Abstract

Diet plays an important role in the management of irritable bowel syndrome (IBS). Individuals, with and without their health care professionals, often adopt dietary interventions or undertake dietary adjustments to help self-manage their condition. Higher prevalence rates for disordered eating and an increased risk towards eating disorder development have been observed within IBS populations, however it is unclear how to interpret these patterns with the wider relational and temporal contexts of IBS related dietary practices having received little attention. Drawing on 26 semi-structured online interviews conducted with women from Aotearoa New Zealand and the digital photo diaries they created, this qualitative study explored the intersection between dietary practices prescribed and/or adopted for the management of IBS and disordered eating/eating disorders. Informed by DeleuzoGuattarian concepts of assemblage, becoming, territory, the refrain, stratification, rhizome, understandings of time as non-linear and the DeleuzoSpinozist question ‘what a body can do’, a post qualitative analytic process was undertaken to explore how different IBS related dietary practices were produced through various ‘IBS eating assemblages’. Findings highlight how IBS related dietary practices were shaped by various bodily, relational, temporal and socially stratifying components (such as norms, feminine appearance ideals, postfeminist healthism and healthy eating guidelines) which assembled in various configurations to produce new and different ways of engaging with (and avoiding) food. Bodily precarity experienced in relation to the sudden and unpredictable nature of severe and debilitating symptom onset, meant that restricted dietary practices were often necessarily adopted to enable bodily stability and life continuity, leading to new and different understandings of healthy/unhealthy eating. For some, IBS related dietary practices had produced new and affirmative ways of engaging with food. These included extending the process of eating beyond the individual, engaging with the material and sensory aspects of food and deeply attuning to embodied sensations in ways which facilitated intense feelings of wellness and enhanced social connections. However, for those with histories of food/body distress, IBS related dietary practices which had necessarily required the elimination or avoidance of certain foods or food groups, had the potential to create new hierarchies of food avoidance which made food/body management more difficult. These findings have implications for how dietary practices considered problematic within ‘normal’ populations, might be understood as adaptive, functional and health enabling by those managing IBS symptoms. Findings may further enrich understandings of IBS related dietary management in ways which may assist health care practitioners, dietitians and researchers to better support women with IBS.