Inflammatory bowel disease (IBD) is neither caused nor healed by food and diet alone. Still, food can have real physical and emotional consequences for people living with IBD, and their relationship to food may be more complicated than the average person’s. It’s no surprise that issues with food, such as disordered eating as well as undernutrition or malnutrition, may be common among people living with IBD.
Here’s what to understand about IBD and unhealthy or disordered eating habits, as well as how to foster a better relationship with food if you have IBD.
What Is Inflammatory Bowel Disease?
IBD is a type of chronic, relapsing-remitting, autoimmune disorder that largely affects the digestive system or gastrointestinal tract and interferes with proper digestive functioning. Crohn’s disease and ulcerative colitis are the two most common types of IBD. It’s believed that IBD is caused by a combination of environmental factors in people who are genetically susceptible to the condition. While no cure currently exists for IBD, it is a manageable disease with several medical interventions and lifestyle adjustments available to help treat it.
During flares, a person with IBD may experience symptoms such as abdominal cramping, diarrhea, fecal incontinence, weight loss, decreased appetite, and other symptoms that can make food and eating difficult subjects.
What Is Disordered Eating?
When a person eats in a manner that becomes harmful to their physical or emotional health, it’s called disordered eating. Disordered eating could look like eating too little or too much, or developing strong emotional responses to foods or the act of eating itself. Disordered eating could also involve feeling like your relationship to food, overall, is out of your control, and your thoughts, feelings, and behaviors around food and eating may command an inordinate part of your time or emotional energy.
A person with disordered eating or a diagnosed eating disorder may try to change their food-related behavior but may often return to old unhealthy thought and behavior patterns without proper treatment. Fostering a healthy relationship between food and your body and your IBD early on is important.
The Complex Relationship Between IBD and Food
As humans have evolved, eating has become much more than just a survival instinct. Food is commonly at the center of social events, special occasions, and entertainment, and we often associate food with emotions and memories, both good and bad. Food’s multi-layered relationship to our physical and emotional health and well-being is complex in general. When living with IBD, the relationship between food and eating can become even more complicated and emotionally fraught.
For instance, there are times when a person with IBD cannot eat due to their physical symptoms. Or they might experience anxiety and mental discomfort when it comes time to eat something. For some people with IBD, food can trigger real fear: Will this meal cause a flare up? What if this meal makes my ostomy bag leak? What if this food makes me urgently need the restroom? Last time I ate this, I experienced pain, embarrassment, or stress.
Sometimes it’s just easier to avoid the stress and ‘what ifs’ by, for instance, restricting or avoiding timely and adequate food intake. When so much stress surrounds when and what you eat, it can be a slippery slope to unhealthy eating habits, an unhealthy relationship to food, eating disorders, and the compounding mental and physical health issues these things cause.
Because IBD interferes with the proper absorption of nutrients via the digestive system, a person with IBD might not get the nutrients they really need. Despite regular eating, a person may still feel hungry because the body craves more nutrients. They could find themselves overeating but not really addressing the underlying issue, which is undernutrition. This can lead to an unhealthy cycle of binging (overeating) and restricting food intake.
Food and Physical Changes
It’s normal for one’s body image and self-perception to take a hit when dealing with the myriad life changes, including diet and eating changes, due to IBD. People with IBD often experience dramatic weight fluctuations. IBD can also impact a person’s energy levels, which can further contribute to trouble maintaining a healthy weight. Some IBD treatments, such as corticosteroids, can cause weight gain or even hair loss. Ulcerative colitis hair loss is a common side effect of medication, but it can also be due also to poor nutrition in IBD.
How To Build a Healthy Relationship with Food and IBD
Having a healthy relationship with your body and the food with which you nourish it is important for both your mental and physical health. A healthy relationship to food will make eating in support of your health an easier and more enjoyable experience. There is no single diet recommended or prescribed for those with IBD, so adopting a balanced, varied diet comprising the healthiest foods that do not aggravate your symptoms can be a vital part of minimizing IBD symptoms. What you eat may even help you achieve remission.
To foster a healthy relationship with food when living with IBD, the following steps can help.
- Educate yourself about the specifics of your own IBD — everyone’s illness is different.
- Work closely with your treating healthcare providers (including a nutritionist) to ensure a balanced, nutritious diet.
- Learn about how certain foods affect you and your IBD; knowledge can bring comfort and confidence.
- Ask for help and get support if and when you need it. Speak to your doctor or other trusted healthcare professional if you notice anxieties, or other habits like binging and restriction, developing around food.
Consider finding an in-person or online support group for people with IBD wrestling with food issues. You may also benefit from professional therapy to gain the tools necessary to establish a healthy relationship with food or to break your disordered eating habits.