Though a relatively fun and lighthearted TikTok and Twitter trend, the phrase “hot girls with stomach issues” actually has real weight behind it. Ironically, it seems conventionally attractive people — those assigned female at birth (AFAB) in particular — share a common struggle with gastrointestinal issues. This includes IBS, Crohn’s disease, dyspepsia or other disorders that cause significant gastrointestinal discomfort. Although these issues are not new, their increased diagnosis is, indicating a potential increase in their prevalence or awareness. But why now and why among millennials and Gen Z in particular?
The information age has undoubtedly contributed to this phenomenon, as the ability to research or self-diagnose anything and everything is ever-present. Regardless, the physical and psychological issues plaguing millennials and Gen Z differ from those of previous generations. For example, compared to Gen Xers aged 34-36, millennials of the same age were 37% more likely to experience hyperactivity, 18% more likely to suffer from major depression and 15% more likely to be diagnosed with Crohn’s disease or ulcerative colitis, according to a 2017 millennial health index published by Blue Cross Blue Shield.
Research points to a variety of factors contributing to this apparent shift in prevalence of not only gastrointestinal issues, but also other health conditions. Most predominantly, research cites one contemporary factor unique to millennials and Gen Z: the rise of the internet and, more specifically, access to technology. Millennials matured at the turn of the century when the internet was just gaining prominence while Gen Z has been coined “digital natives” because internet technology and smartphones have been largely ubiquitous for most of their lives.
Interestingly, 6 out of 7 health issues disproportionately affecting millennials, compared to older generations, are directly tied to increased technological use. According to a 2018 Bustle.com article, issues included sensitivity to light, neck pain, eye strain, acid reflux, hearing loss and mental health issues such as anxiety and depression. Additionally, pain precipitates a subsequent increased use of painkillers such as Ibuprofen, which can exacerbate gastrointestinal issues, creating a negative feedback loop for its more frequent users.
Therefore, it is unsurprising that Gen Z and millennials, who are more tech-savvy than previous generations, have been affected by so many gastrointestinal issues. Perhaps the most alarming side effect of this increase is the correlation between stomach problems and anxiety and depression. Gen Z reports higher rates of mental health concerns than any previous generation, and recent studies have shown those with IBS and ulcerative colitis “reported excess prevalence and severity of depression as well as anxiety, relative to healthy controls,” according to studies conducted by Cedars-Sinai Medical Center, Los Angeles, and the Naval Medical Research Center, Maryland.
Among those with ulcerative colitis, rates of depression were 39% higher and excess anxiety was 42% higher than healthy controls, while those with IBS reported a 33% increased difference in depression and 19% increased difference in anxiety, respectively. The findings suggested this association might be attributed to the psychological effects of chronic or debilitating disease.
Stress greatly impacts gut health, particularly among people with chronic bowel disorders such as inflammatory bowel disease or IBS. According to the American Psychological Association, stress affects the nervous system and uncomfortable gastrointestinal symptoms may be due to nerves in the gut being more sensitive, as well as changes in gut microbiota, changes in how quickly food moves through the gut and changes in the gut immune response.
Even though millennials and Gen Z have experienced greater levels of stress than those of previous generations, their respective causes have key differences. Certain environmental factors have contributed to a trend of chronic collective stress among Gen Z individuals in particular, such as heightened concern about student debt, gun violence in schools and sexual harassment as well as societal phenomena such as growing up amid political turmoil, the Great Recession and the aftermath of 9/11; these issues circulate in a social media echo chamber, and the inability to directly impact them induces stress, anxiety and depression within Gen Z, who are just now becoming eligible to vote or incite actual social change.
Of course, stressors and gastrointestinal issues can affect anyone at any age but unfortunately “hot girls with stomach issues” denotes a key trend that particularly affects women. In many cases, IBS and other gastrointestinal issues are more common in those assigned female at birth, whose gastrointestinal systems behave differently than those assigned male at birth because of sex-related features in the brain, according to the American Physiological Society.
Tanja Babic, a researcher at Penn State Hershey College of Medicine, discovered that cells that control the movement of food through the intestines respond more slowly to brain inputs in people who are born female than in those who are born male. Other studies suggest the use of hormonal birth control causes more general gastrointestinal discomfort, such as gas, bloating or constipation, because chronic medications, such as the birth control pill, alter gut microbiomes the most.
It’s also unsurprising that issues disproportionately affecting or prevalent among women are often under-researched and under-diagnosed due to unfortunate gender biases in medicine and medical research. The lack of research surrounding gastrointestinal issues and their causes is an unfortunate side effect of such neglect.
Personally, I do not suffer from IBS or Crohn’s disease, but rather a rarer gastrointestinal disorder called delayed gastric emptying or gastroparesis. Much to my dismay, it also disproportionally affects women, as out of 100,000 people, only 10 men but around 40 women will have it. If diagnosed and treated properly, it is more a nuisance than a debilitation, but because it is so heavily under-researched, many with idiopathic gastroparesis — or gastroparesis with no known origin — go undiagnosed. Now, as much as I would like to be considered a hot girl with stomach issues, I often balk at this descriptor because I find it depressing how nonchalant society’s response is to legitimate women’s issues.
Nevertheless, being a member of Gen Z has some relative advantages; even though gastrointestinal research leaves much to be desired, there is more information out there now than ever before, making it easier to ascertain individual symptoms, treat diagnoses and find commonality among those with similar conditions. Overall, though, it is important to take millennials and Gen Z seriously when discussing gastrointestinal symptoms. As exemplified by their correlation with mental health, they could be a signifier of more serious underlying issues, not only individually but of society broadly.