What Is An Elimination Diet?

Your gut is one of the most important and most sensitive of your body’s systems. The gut affects the body so much that scientists are going as far as saying your gut is your second brain! If your gut is out of balance, it can cause an array of issues that result in much more than just a bellyache. Many health concerns can be attributed to something not agreeing with your digestive system and causing inflammation in the gut.

But what’s causing all of this inflammation? 

If you’re experiencing chronic digestive discomfort, which is likely a result of inflammation, you might want to consider a consult with your gastroenterologist about trying an elimination diet.  

What Exactly is An Elimination Diet?

The purpose of an elimination diet is not to lose weight. The goal is to determine which foods aren’t agreeing with your body, often causing underlying symptoms such as chronic gastrointestinal discomfort, skin issues, difficulty sleeping, or chronic fatigue. By eliminating certain foods, or entire food groups, you can see which foods are causing or making certain symptoms worse. 

How Do Elimination Diets Work?

As the name implies, an elimination diet works by eliminating certain foods for a period of several weeks with the goal of finding out which ones are the cause of a food reaction or intolerance. After the foods have been removed for a set amount of time, you start slowly reintroducing them one at a time and recording which ones have no effect and which ones bring back symptoms. If symptoms return after reintroducing a certain food, it can be assumed that it was the cause of distress.  

What Kinds of Elimination Diets Are There?

There are no set guidelines for following an elimination diet except those set by your healthcare provider. There are, however, more commonly used elimination diets:

Elimination Diet

The basic elimination diet is typically used to detect food allergies and sensitivities. This type of diet removes all of the possible trigger foods at once. Then, each food is reintroduced to see if it causes the symptoms the person was suffering from. Typically, people who follow this diet refrain from foods like dairy, eggs, meat, nuts, shellfish, citrus, wheat, gluten, processed foods, and soy products. 

You can also try a simplified version of a basic elimination diet by eliminating only gluten and dairy. 


For people with irritable bowel syndrome, a healthcare provider might prescribe the low-FODMAP diet. 

Gluten-Free Diet

All foods containing the protein gluten are restricted when following a gluten-free diet. That means no wheat, barley and rye, seitan, triticale, and oats. Processed foods are also usually a no-go as well. 


The GAPS diet is an acronym for Gut and Psychology Syndrome and is often used to heal the gut lining. This diet is 2-part. The first phase is an introduction diet which is targeted specifically for people with more severe digestive issues. The first stage includes 6 steps, and once you complete those you can move on to the full GAPS diet. The GAPS diet is fairly intensive and should be completed under the direction of your gastroenterologist. 

Who Can Benefit from an Elimination Diet?

Just about anybody can benefit from trying an elimination diet. Your gut health affects your entire body, so you’re going to feel it if something isn’t agreeing with your digestive system. Many people start an elimination diet to target food that is causing gastrointestinal distress such as:

But, there are many others that can benefit from an elimination diet including people with conditions such as:

  • Migraines

  • Arthritis

  • Psoriasis

  • Acne

  • Difficulty sleeping

  • Autoimmune disorders 

How to Implement an Elimination Diet

Step 1- Planning

The first thing to do when trying an elimination diet is to come up with a clear plan. What symptoms are you trying to alleviate? What are your goals in doing this diet? Work with your healthcare provider, gastroenterologist, and/or nutritionist to determine which foods might be causing you issues. If you already know of some foods that cause issues for you, make a list. Make a list of any symptoms you are experiencing so you can see if they are food-related. Your healthcare provider might also suggest you keep a food journal several weeks prior to starting an elimination diet. This is so you can record how you feel and how that corresponds with what you eat. It will help your healthcare provider determine what kind of elimination diet is best for you. 

Starting an elimination diet is no easy task. In order for the diet to be effective, you will need to completely eliminate the foods set out by your healthcare provider without exception for 2-4 weeks. There are no cheat days on this diet. If you accidentally or choose to eat one of the restricted foods, you’ll need to start back at square one. Before starting, it’s important to determine whether or not now is the best time to embark on this journey. Ask yourself:

  • Do you have any stressful or major life events coming up?

  • Any big trips planned?

  • Do you have the skills, resources, and energy to try a completely new way of eating?

  • Are your family and friends supportive and willing to accommodate your new temporary dietary restrictions?

Step 2- Avoiding

Once you have your prescribed elimination diet, your job is to avoid all of the restricted foods. You’re going to have to be diligent with planning so you don’t fall back on old habits. You’re also going to have to be somewhat of a researcher to make sure you don’t unintentionally eat things you should be avoiding. That means meticulously checking labels and ingredients. This step takes a lot of work. If you’re avoiding dairy, for example, the label might not explicitly say it contains dairy. You’ll to check for lactose, casein, and whey and know that these are also considered dairy. For the best results, if you eat a restricted food, you should start over. 

Although food is the primary focus of the elimination diet, your healthcare provider will probably recommend including alcohol on your restricted list. 

You might feel like you have nothing left to eat once you cut out all of the restricted foods. The elimination diet is only meant to last for a few weeks, so there is a light at the end of the tunnel. In the meantime, lots of lean protein and vegetables are your go-to.

It’s also important not to get discouraged should your symptoms initially worsen. It’s not uncommon for things to get worse during the first week of an elimination diet. Worsening symptoms could be due to the drastic change in your diet, the result of a stressful day, or they could be revealing a deeper, non-food related issue. If you experience a worsening in symptoms, check in with your healthcare provider. 

Step 3- Challenging

If you’ve been diligently doing your elimination diet for 2 weeks but haven’t seen an improvement in symptoms, continue on for an additional 2 weeks. If, by the end of 4 weeks symptoms still have not improved, stop the diet and talk with your healthcare provider to determine what else might be causing your symptoms. 

Once you hit the 2-week mark and have been symptom-free for at least 5 days, you can start reintroducing foods, one at a time. If you introduce one food and for 3 days experience no adverse reactions, try reintroducing another food. Record the outcome in your food diary. If you start experiencing symptoms after reintroducing a food, make a note in your food diary, remove the food again, and re-test it in 4 or 5 days. If it still causes issues, remove it altogether and proceed with the next food. Follow this pattern until you’ve reintroduced all the foods you’ve eliminated. 

Step 4- Creating a New Diet

It’s important after completing an elimination diet to gradually return to a normal diet. You will put your digestive system through a world of hurt if you go out and eat an entire cheese pizza after abstaining from gluten and dairy for 4 weeks. Instead, start small with one new food per week and start with small portions. If you experience any symptoms, annotate them in your food journal. 

If you’ve had a successful round of elimination diet and found a food that does irritate you, that’s great! Make sure you account for the lack of that food in your new diet and supplement as needed. For example, if you eliminate dairy, turn to other sources high in calcium such as spinach and other leafy greens. It’s important to make sure you are still getting adequate nutrition from the foods you are eating. 

If you come across a food that causes a sensitivity, you might be upset if it’s one of your favorites. Just because the food is an irritant does not mean you have to eliminate it from your regular diet until the end of time. It simply means that you are more educated about your own body and what works and doesn’t work. If you want to indulge in your favorite treat, like clam chowder for those in the greater Boston area, go ahead! But now you’re equipped with the knowledge to make the best decision when and how much of that particular food you can eat and still feel good.