SIBO controversy and clinical nuance

In this episode of The Mind-Gut Conversation, Dr. Emeran Mayer sits down with Kate Scarlata, RDN, an internationally recognized dietitian, bestselling author, and leading authority on dietary therapies for IBS and chronic digestive disorders.

Drawing from her personal medical journey and decades of clinical experience, Kate offers a deeply insightful and refreshingly nuanced look at some of the most debated topics in gut health today.

Together, they explore the real therapeutic value of the Low FODMAP diet, who it helps, who it doesn’t, and why its success hinges on personalization rather than restriction.

The conversation moves through major controversies in the field, including SIBO over-diagnosis, the confusion around non-celiac gluten sensitivity, the true causes of bloating, and the myth of detox diets.

Throughout, Kate emphasizes a balanced, science-guided, and compassionate approach that prioritizes patient well-being, food enjoyment, and quality of life over dogma.

Key Topics Covered:

• The Low FODMAP diet: benefits, misconceptions, and why personalization matters

• SIBO: over-diagnosis, breath test pitfalls, and when treatment does make sense

• Non-celiac gluten sensitivity: separating nocebo effects from true reactions

• Bloating: dietary vs. physiological vs. stress-related causes

• Why detox culture misses the point—and what the body’s built-in detox systems already do

This is an honest, evidence-informed, and highly practical discussion for anyone navigating digestive symptoms, or for clinicians seeking a more grounded way to help their patients thrive.

Please leave any comments or feedback on our Podcast in the comments, we'd love to hear what you think about it.

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Website: https://www.emeranmayer.com

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Chapters:

00:00 – Welcome & Kate Scarlata’s Story

04:40 – How Personal Experience Shaped Her Career

06:05 – The Low FODMAP Diet: What People Get Wrong

10:16 – How to Personalize Dietary Therapy

15:16 – SIBO: Why It’s Overdiagnosed

18:22 – When SIBO Is Real (and When It Isn’t)

24:50 – Understanding Bloating & Symptom Patterns

29:32 – Gluten Sensitivity: Myth, Nocebo, or Something More?

36:45 – Beyond Diet: Stress, Motility & the Gut–Brain–Microbiome System

44:50 – The Truth About Detox Culture

47:23 – Supporting Gut Health Through Daily Habits

50:14 – How Kate Eats & Lives Today

52:31 – Final Thoughts