Functional gastrointestinal disorders (FGIDs) are very common (up to 98%) in patients with an eating disorder (ED). Boyd et al. discuss in this issue of Neurogastroenterology & Motility that FGIDs can persist independently on the outcome of the ED. Their findings leave room for speculation on the mechanisms underlying FGIDs in patients with an ED. FGIDs result from a complex interaction of biological, psychosocial and social factors. The altered eating behavior seen in EDs is strongly associated with disturbed gastrointestinal sensitivity and motor physiology. Moreover, psychiatric co-morbidities in ED patients are also frequently found in FGIDs. The motor and sensitivity disturbances together with psychiatric co-morbidities can lay the foundation of a FGID. Once established the psychological and physiological disturbances can perpetuate and strengthen each other resulting in a FGID that can persist independently of the ED that originally caused the motor and sensitivity disturbances.