Why IBS is not just a medical problem, it’s a design flaw

Tummily's founder, Alison Williams, in a garden, holding a bowl of seafood linguine garnished with green herbs.
The personal story behind Tummily

This story starts in 2021. My partner returned home from a dietitian’s appointment with a flyer that many may be familiar with; “The low FODMAP diet, foods to avoid, foods to enjoy”. After years of battling Irritable Bowel Syndrome (IBS), with its rollercoaster of symptoms and countless hospital visits, the low FODMAP diet offered a beacon of hope.

Given that IBS is incurable, it’s common for doctors to recommend the low FODMAP diet as a solution for IBS. This is unsurprising when you look into the research- In clinical trials the diet is proven to effectively ease symptoms in 86% of people with IBS.

We jumped right in, armed with cookbooks, apps and a fridge door that doubled as our weekly meal planner. We diligently looked up each ingredient in every recipe to double check they were ‘in the green’- a painful process I wouldn’t wish on my worst enemy! My partner kept a meticulous food and symptom diary, ready to report back to his dietitian. But it was all so hard. His repertoire of foods was so restricted and boring, and to top it all off- his symptoms didn’t improve. Despite our best efforts, we hit a wall.

My husband didn’t fail this diet due to a lack of willpower or best efforts, but to a system that’s not designed for success. As a foodie and a user experience designer, I couldn’t just stand by. Then it hit me: his inability to implement this diet isn’t a medical issue; it’s a design flaw.

 

If you’ve failed the low FODMAP diet, or it hasn’t worked for you, you’re not alone, and it’s not your fault.

While the past twenty years have been defined by a digital revolution, our approach to the low FODMAP diet has barely evolved. Those of us attempting this horrible diet are required to learn how much of each FODMAP group we can tolerate, and then calculate the complex FODMAP contents of each food we’re eating. This is essentially a complex data challenge- perfectly suited to a digital solution. In an age where my phone can remind me to water my plants, why are we not using technology to tackle IBS management head-on? Why are we still pinning paper handouts to our fridge and scrolling through arduous food lists?

Fuelled by the injustice of it all, I took off my apron and picked up my keyboard, on a mission to understand why this diet fails so many outside the clinical setting. As a user experience designer, I’m driven to deeply understand a problem. So I researched this issue, conducting surveys, consulting with dietitians and speaking to you, low FODMAP dieters, to pinpoint the friction points. 

Here’s where I learned you’re going wrong:

     

      1. You’re trapped in a restrictive elimination diet: Many don’t realise the low FODMAP diet includes a crucial reintroduction phase. It’s about identifying triggers, not just avoiding a long list of foods indefinitely. Yet, fewer than a quarter of the people I spoke to had navigated this step successfully, with many unaware it was even part of the plan.

      2. You struggle to ‘personalise’ your low FODMAP Diet: Understanding your FODMAP sensitivities is one thing; translating that into a varied and enjoyable diet is another. The effort to research every ingredient can be overwhelming, leading many to stick to a monotonous, safe menu.

      3. You’re accidentally ‘stacking’ FODMAPs: FODMAP stacking happens when you eat several low FODMAP foods close together, which combined can exceed your threshold. Your breakfast and lunch both appear to be low FODMAP, but eat them together and you’re running to the toilet. Even dietitians commonly struggle with this pitfall.

      4. Dietitians are ill-equipped to help you: Dietitians are fed up too. They often lack the resources to provide personalised FODMAP guidance. Despite their best efforts, they’re under-resourced and unable to offer the tailored support you need.

    If you’ve failed the low FODMAP diet, or it hasn’t worked for you, you’re not alone, and it’s not your fault. While 86% of people manage to ease symptoms in clinical trials, only about 25% of people manage to implement this diet plan successfully in the real world, with even fewer managing symptoms.

    For those of us unlucky enough to have to follow the low FODMAP diet, mealtime can trap us in a cycle of bland and nutritiously inadequate meals, robbing us of the joy of eating. Honestly, who wants to crack open a textbook just to figure out dinner? We need technology to do the hard work for us. We need a digital solution to intuitively guide us to understand our FODMAP tolerances, making it clear what we can and should eat without stripping away the joy of food. Food should be about happiness and discovery, not stress and restrictions.

    This isn’t just a story about a diet; It’s a call to action for a more nuanced, compassionate approach to health management—one that recognises the individual behind the symptoms.

    Armed with these insights, I’ve embarked on a mission to bridge the gap between clinical efficacy and real-world success. Tummily is more than just a tool; it’s a testament to the power of empathy, innovation, and the relentless pursuit of a better way.

    As I reflect on this journey, I’m reminded of the day my partner came home with that flyer, full of hope. Now, as we stand on the brink of a new chapter with our app, I’m filled with a renewed sense of purpose. This isn’t just our story; it’s a beacon for anyone who’s felt overwhelmed by the challenges of managing IBS. We’re on the cusp of reimagining a future where an 86% success rate is not just a statistic but a reality for everyone living with IBS.

    If you can relate to our story please share yours in the comments below, and you can show your support by joining the Tummily waitlist

    Stay tuned. The journey is just beginning, and together, we’re paving the way for a future where managing IBS is as simple and joyful as cooking your favourite meal.

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