How to Follow an Elimination Diet Without Eliminating Your Healthy Relationship With Food

Are you at the point of not knowing what the heck is going on with your body and you’re ready to try an elimination diet? Or have you been on an elimination diet before that made you question your entire relationship with food? Unfortunately, elimination diets can often lead to a more damaging relationship with food if you’re not properly educated on the purpose, duration, and logistics of the diet, if you’re not following up with a healthcare professional, or if you experience weight changes while on the diet.

For anyone who has ever struggled with their relationship with food or their body, read this article before embarking on any kind of elimination diet.

First of all, what is an elimination diet?

An elimination diet is not just cutting out bread for a week to see if your mind feels clearer. It’s the complete elimination of certain foods typically known to cause allergies, food sensitivities, inflammation, reflux, or other symptoms. The diet involves first eliminating a number of foods which may be problematic, assessing if your symptoms have decreased, and then adding back in food items one by one to determine which food(s) triggers your symptoms, and in what amounts. Then, you add all foods back into your diet which did not trigger symptoms. Thus, you can find out the specific food or foods which are contributing to your symptoms.

Symptoms may include, but are not limited to: constipation, diarrhea, bloating, headache, lethargy, hives, abdominal pain, joint pain, rashes, eczema, and heartburn.

How do I know what to eliminate?

It depends on your symptoms. If you think you have a food allergy (note: if you’ve had an anaphylactic reaction at any point, detecting food allergies is a job for your allergist, not a diet) or intolerance, you’re going to need to eliminate a larger number of foods. If you are having chronic GI upset, you may go on a FODMAP diet (which is actually an elimination diet- you do not need to eliminate all FODMAPs if you are not sensitive to them!!). If you are having reflux, there are specific foods to eliminate. In all cases, you should also eliminate the foods you typically eat, even if they are on the list of “allowed” foods.

Your best bet, of course, is always to see a registered dietitian nutritionist who can tailor the diet to your specific needs, monitor your progress, and recommend recipes within your restrictions.  You should also keep a food and symptom diary throughout the process to help guide your journey.

What happens if I cheat on the diet?

This is not a typical diet. Think of the elimination diet more as an experiment and you are the test subject. If you “cheat”, you alter the final results. However, it would be important to note why you “cheated”? Is the diet too restrictive? Do you have no idea what to eat? That’s why it’s helpful to have a registered dietitian nutritionist to help guide you. Are your symptoms not really that bad that you feel you need a diet? If that’s the case, don’t torture yourself! If you are not upset by whatever symptoms you’re having, you may not need to find out their cause right now.

I feel better, what now?

Woohoo, that means the diet worked! Now comes the challenge phase which is very important and this phase is one people often skip or rush. You will need to add back in one food at a time, generally only one food per week. Try one serving of the food item at one meal on one day. If you don’t have symptoms, great! Now try that food again within the week. Perhaps prepare it a different way, just to be sure this food does not cause symptoms. If you do experience symptoms after consuming the food, try it again within the week in a smaller portion to assess the amount of the food you can tolerate. You may not be able to tolerate any of the food item, and that’s important to note, as well. Before moving on to re-introducing the next food item, make sure your symptoms have resolved.

Once you’ve re-introduced all food items, you will know which ones, if any, are problematic and must be avoided in order to avoid your symptoms. This is the ultimate desired outcome of the diet.

I don’t feel anything, what now?

If you’re still not feeling better after at least 2 weeks, give the diet another 2 weeks. Then, give it 2 more weeks. If you’re still not feeling better, then it might be time to consider that you did not eliminate enough foods, or that your symptoms are not diet related.

If you actually feel worse on the diet, take a look at your food and symptom diary and assess if any of the foods you’ve substituted are causing your symptoms.

I lost weight, this is a great diet!

We already said this is an experiment, not really a diet. The end goal is to allow yourself to feel better, not to change your body shape or size. If you lost weight because you started eating different foods and found yourself inspired to live a healthier lifestyle and take up exercise, then cool (although during this experiment is a bad time to make any other lifestyle changes because you can alter the results). But if you lost weight because you were barely eating, this could indicate that your true motivations for the diet were to restrict. Since diets suck and this was just an experiment, you may have altered the results because you’re going to feel different re-introducing foods when you’re restricting than when you’re well nourished. It’s not your fault if you do lose weight by nature of potentially eating less, but remember that in the midst of your experiment is not a good time for weight loss or dieting.

What happens if this diet triggers my disordered eating behaviors?

That’s the benefit, and purpose, of conducting this diet under the guidance of a dietitian. You will have the support of someone who is able to re-direct that focus from restriction to a focus on health. If you are conducting this diet by yourself, reach out to friends, family, support people, or your therapist. Let them know how the diet is affecting you. And, if you’re in the middle of the diet, it may be time to call it quits if you do not feel adequately supported and the main focus has turned to restriction and you’re obsessing about what you can eat and your body shape and size. You can always try it again when you’re feeling more strengthened and supported.

You mean I don’t need to eliminate those foods forever?

Nope! If you did, then there would be no need for the challenge phase of the diet. The only foods you need to eliminate are the ones which triggered symptoms.

What happens if I need to eliminate a certain food?

Then you learn to live without it. You clearly conducted this diet because you had a symptom which caused you distress. Now that you know what causes that distress, rejoice! You may need to grieve the loss of the food item, and that’s perfectly normal. You may even feel like you need to eat it every now and again. In fact, you may even completely ignore the results of this experiment. How you choose to respond is your choice. You are completely in control.


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Seeking additional support in your relationship with food and your body? In search of an experienced eating disorder registered dietitian nutritionist in the Long Island, New York area or virtually in New York, New Jersey, or Connecticut? Send Christina an email to learn more about 1:1 nutrition therapy sessions!

Published by Christina Frangione, MS, RD, CDN, RYT

Christina Frangione, MS, RD, CDN, RYT is a Registered Dietitian Nutritionist serving the Long Island, New York City, and New York State areas helping clients with eating disorders and disordered eating recover their relationship with food and their body. She utilizes a Health at Every Size® approach and supports Intuitive Eating and knows that while she is the food and nutrition expert, you are the expert of your body and life.

15 thoughts on “How to Follow an Elimination Diet Without Eliminating Your Healthy Relationship With Food

  1. A few years ago, I followed a diet with my husband, and while he didn’t make any great discoveries, I found out I had problems with wheat. More recently, I had pain all over my body, and was certain I had fibromyalgia, or something like it. I did another elimination diet. Turns out tomatoes and green peppers were the culprit. Thank you for spreading the news about elimination diets-they are so worth it.

  2. I have been back and forth about trying the AIP diet. I am just scared that I won’t have any options left for me to enjoy. I have a sensory disorder and certain food textures trigger that, This article is very helpful!

    1. Hi April, I’m so glad you found this article helpful. It can definitely be challenging to think about trying such a restrictive diet. Perhaps consider setting a time limit for the diet (admittedly not too familiar with that particular diet) so you know you don’t need to restrict all those foods forever. If it can help you feel better in the long run, it may be worth trying. You may want to have a conversation about it with your healthcare provider.

      Good luck and feel free to let me know what you end up doing!

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