By Erin Gilmore, LICSW, CEDS-C, EMDR Therapist, NASM Nutrition Coach

Introduction:

In a culture obsessed with low-carb diets and food rules, it’s easy to forget one simple truth: carbohydrates are not the enemy—they’re essential for your health, longevity and recovery.

As a therapist specializing in eating disorders and trauma, I often work with people who have learned to fear carbs. They’ve been told that carbs will make them gain weight, spike their blood sugar, or make them “lose control.” But none of that reflects the actual science of how our bodies—especially our brains, bones, and hormones—function.

Let’s break down why your body needs carbs, especially in recovery.

Carbs Fuel Your Brain:

Your brain runs almost exclusively on glucose, a form of sugar that comes from carbohydrates. Without enough carbs, many people experience brain fog, poor concentration, mood swings, and irritability.

In fact, chronic low-carb intake can mimic the symptoms of anxiety or depression (Lieberman, 2003; Benton & Donohoe, 1999). Glucose is the brain’s primary energy source, and even brief periods of glucose deprivation can impair brain function (Mergenthaler et al., 2013). When we nourish the brain with steady, adequate carbohydrates, mental clarity, mood stability, and energy improve.

Carbs Support Hormones (Including Stress, Thyroid, and Sex Hormones):

Hormonal health depends heavily on adequate energy availability, and carbs play a crucial role:
– Cortisol (your stress hormone) rises when carb intake is too low. Your body perceives restriction as a threat and ramps up survival mode (Mountjoy et al., 2018).
– Thyroid hormones, especially T3, require enough carbohydrates to convert and function properly (Misra & Klibanski, 2014).
– Reproductive hormones like estrogen and progesterone also suffer when carbs are restricted, especially in those with hypothalamic amenorrhea (De Souza et al., 2007).

Carbs help tell your body, “You’re safe. You’re fed. You can rest.

When you eat carbohydrates—especially in a consistent and adequate way—it sends a powerful signal to your nervous system: you are not in danger. From an evolutionary and biological perspective, access to steady fuel, particularly glucose, communicates to your body that resources are available, and there’s no need to stay in a state of high alert. This helps lower levels of cortisol (your stress hormone), regulate your hypothalamic-pituitary-adrenal (HPA) axis, and restore parasympathetic nervous system functioning—the “rest and digest” state that allows for healing, hormone balance, and emotional regulation (Mountjoy et al., 2018).

In contrast, when the body doesn’t receive enough carbohydrates, it interprets the deficit as a form of threat or famine. Even if you’re not consciously stressed, your biology reacts as though something is wrong—raising cortisol, slowing metabolism, impairing thyroid conversion, and reducing reproductive function. Over time, this can lead to symptoms like fatigue, anxiety, insomnia, missed periods, and difficulty concentrating. But when you reintroduce carbs, especially as part of consistent, gentle nutrition, your body begins to unlearn that threat. It shifts from survival mode to a state where it can trust, rest, and repair.

For those in eating disorder recovery, this shift is especially critical. Carbohydrates are not just energy—they’re reassurance. They are a form of nourishment that communicates: You are no longer starving. You are safe now.

Carbs Build Bones:

Did you know that bone formation requires carbohydrates? Carbs help regulate insulin, which supports bone-building processes (Golden et al., 2014). In a starved or restricted state—especially in eating disorders—your body pulls calcium from the bones to keep your blood levels stable. Long-term carb restriction can contribute to decreased bone density, increased fracture risk, and osteopenia or osteoporosis (Katzman & Misra, 2019).

Whole Carbs Come with Nutrients Your Body Loves:

Carbohydrates aren’t just about sugar. They come bundled with:

– Fiber (supports gut health, blood sugar regulation, and estrogen detox)
– B vitamins (essential for mood, energy, and metabolism)
– Magnesium and potassium (key to muscle and nerve function)
– Prebiotics (feed your beneficial gut bacteria)

In Recovery, Carbs Are Medicine:

In eating disorder recovery, the body is trying to rebuild trust, regulate hormones, repair tissues, and restore the nervous system. All of that takes energy, and carbs are your body’s preferred energy source.

Carbs are often the first thing clients restrict and the last thing they’re willing to reintroduce. But over and over again, I witness what happens when they do: anxiety decreases, sleep improves, cravings stabilize, and joy returns.

Carbs aren’t just fuel—they’re a form of nourishment, stability and happiness. . 

Final Thoughts:

If you’ve been taught to fear carbs, I want you to know: Your body is not broken. It’s wise. And it needs carbohydrates.

Letting go of diet culture’s rules can feel terrifying at first. But honoring your body’s need for nourishment is one of the most powerful steps you can take toward healing—not just physically, but emotionally and spiritually.

You deserve a relationship with food that includes freedom, satisfaction, and trust. And yes—that means embracing the humble, life-giving carbohydrate.

References:

• Benton, D., & Donohoe, R. T. (1999). The effects of nutrients on mood. Public Health Nutrition, 2(3a), 403–409. https://doi.org/10.1017/S1368980099000566
• De Souza, M. J., Hontscharuk, R., Olmsted, M., Kerr, G., & Williams, N. I. (2007). Drive for thinness score is a proxy indicator of energy deficiency in exercising women. Appetite, 48(3), 359–367. https://doi.org/10.1016/j.appet.2006.10.006
• Gibson, R. S. (2005). Principles of nutritional assessment (2nd ed.). Oxford University Press.
• Golden, N. H., Abrams, S. A., & Committee on Nutrition. (2014). Optimizing bone health in children and adolescents. Pediatrics, 134(4), e1229–e1243. https://doi.org/10.1542/peds.2014-2173
• Katzman, D. K., & Misra, M. (2019). Bone health and osteoporosis in adolescents with eating disorders. International Journal of Eating Disorders, 52(8), 851–859. https://doi.org/10.1002/eat.23134
• Lieberman, H. R. (2003). Nutrition, brain function and cognitive performance. Appetite, 40(3), 245–254. https://doi.org/10.1016/S0195-6663(03)00010-2
• Mergenthaler, P., Lindauer, U., Dienel, G. A., & Meisel, A. (2013). Sugar for the brain: The role of glucose in physiological and pathological brain function. Trends in Neurosciences, 36(10), 587–597. https://doi.org/10.1016/j.tins.2013.07.001
• Misra, M., & Klibanski, A. (2014). Endocrine consequences of anorexia nervosa. The Lancet Diabetes & Endocrinology, 2(7), 581–592. https://doi.org/10.1016/S2213-8587(13)70180-3
• Mountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K. E., Blauwet, C., Constantini, N., … & Budgett, R. (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine, 52(11), 687–697. https://doi.org/10.1136/bjsports-2018-099193