Coping with Inflammatory Bowel Disease’s (IBD) Physical, Mental, and Behavioral Health Implications

Thrive • December 20, 2022

A diagnosis that affects 1.3% of adults in the U.S., inflammatory bowel disease (IBD) can affect physical, mental, and behavioral health. The gastrointestinal condition may also lead to disordered eating and eating disorders. Those with IBD may benefit from a comprehensive treatment approach that holistically addresses their symptoms.

IBD, CROHN’S DISEASE, AND ULCERATIVE COLITIS

Characterized by persistent swelling within the intestines, IBD is a broad term that refers to two different chronic digestive conditions, which are:

  • Crohn’s disease: Can involve any part of the digestive tract; associated with swelling throughout multiple layers of the walls of the gastrointestinal system. 
  • Ulcerative colitis: Affects only the large intestine and rectum with inflammation presenting in the innermost layer of the lining of the colon. 

Unlike inflammatory bowel syndrome (IBS) , IBD involves structural abnormalities within the gastrointestinal system, while IBS is associated with functional complications within the digestive tract. Because the structural abnormalities caused by IBD are visible, clinical tests are typically able to detect the condition. IBS is not discernible on tests.  

SYMPTOMS OF IBD

IBD is a severe illness that can disrupt a person’s life. Symptoms of IBD include:

  • Abdominal pain constipation 
  • Bloating
  • Diarrhea
  • Fatigue
  • Malnutrition
  • Rectal bleeding
  • Weight loss

CAUSES OF IBD

Researchers don’t fully understand the causes of IBD. Still, the condition is possibly linked to a deficiency in the way the immune system reacts to harmful substances in the digestive system. IBD may also be associated with:

  • Family history of digestive issues
  • Disturbance in the balance of bacteria in the large intestine
  • Psychological factors including, stress, anxiety , and depression

HOW IBD AFFECTS MENTAL AND BEHAVIORAL HEALTH

IBD’s implications aren’t limited to physical struggles. Those with IBD may face an increased risk for:

  • Depression : The potentially debilitating symptoms of pain and fatigue in addition to social stigmas and a sense of isolation can contribute to feelings of depression. 
  • Stress and anxiety : IBD can make it difficult to carry out daily activities due to distressing digestive symptoms. 
  • Self-image struggles: IBD can lead to feelings of shame and body dissatisfaction, harming a person’s relationship with themself and their body.
  • Substance abuse : Those with IBD may turn to alcohol and drugs to cope with the mental and emotional struggles stemming from the condition. 
  • Disordered eating : IBD can contribute to restrictive eating behaviors that can become ingrained. 

IBD AND EATING DISORDERS

The relationship between IBD and eating disorders warrants further research. However, the many commonalities between IBD and eating disorders are well-established. The conditions share symptoms of weight loss, gastrointestinal issues , malnutrition , and immune system dysregulation . Because of their similarities, it can be difficult to distinguish whether an eating disorder or IBS is the cause of a person’s symptoms. In cases where IBD and eating disorders coexist , each condition can exacerbate the other. 

Those with IBD may also engage in disordered eating behaviors to control their symptoms. For individuals psychologically predisposed to eating disorders, IBD can contribute to the development of an eating disorder. 

MANAGING IBD

Although IBD has no known cure, the condition can be managed with medical care and therapeutic support. Medical treatment may involve medications, surgery, and other interventions. In regards to mental and behavioral health, modalities including cognitive behavioral therapy (CBT) and mindfulness-based therapies have been shown to help those with IBD .

MIND-BODY CARE FOR INDIVIDUALS WITH IBD

At Thrive Wellness, our interdisciplinary team of primary care providers, mental health professionals, registered dietitians, and other health care specialists are dedicated to providing integrated treatment to those struggling with their well-being, including those with IBD. Through care that encompasses the whole person, individuals with IBD can develop healthy strategies for coping with any physical and psychological struggles related to their condition. Reach out to learn more about our comprehensive health services.

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By Julia Actis, LCSW September 11, 2025
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When Emma was 8, her parents noticed her food choices shrinking. At first, they assumed it was just picky eating — “She’ll outgrow it,” friends said. But by 10, Emma would only eat crackers, cheese, and chicken nuggets. Family dinners became nightly struggles, her growth slowed, and she skipped birthday parties to avoid “strange food.” Her parents felt powerless, her brother grew frustrated, and outings dwindled. What began as food avoidance soon reshaped the rhythm of the entire household. When children avoid food, most parents expect it’s a passing stage. But when restriction deepens, shrinks to only a few “safe foods,” and begins affecting growth or health, families suddenly find themselves in unfamiliar territory. This is often where Avoidant/Restrictive Food Intake Disorder (ARFID) emerges — with effects that extend far beyond the plate. As providers, we need to be attuned to these patterns. It’s tempting to dismiss them as “no big deal,” yet for many families, they are life-altering. Sadly, Emma’s story is not unusual. Mealtimes as Battlegrounds Families living with ARFID often describe mealtimes as emotionally charged, exhausting, and unpredictable. What should be a chance to connect around the table can feel more like a negotiation or even a standoff. Parents wrestle with whether to push their child to try a new food or give in to the same “safe foods” again and again to avoid tears, gagging, or complete meltdowns. This ongoing tension can make mealtimes dreaded rather than cherished. Siblings, too, are affected. Some may feel resentful when family meals are limited to what only one child will tolerate. Others may act out in response to the constant attention the child with ARFID receives. Over time, the dinner table shifts from a place of nourishment and bonding into a stage for conflict, anxiety, and guilt — a pattern that can erode family cohesion and resilience. Social Isolation and Missed Experiences ARFID impacts more than what happens at home; it influences how families engage with the world around them. Everyday events — birthday parties, school lunches, vacations, even extended family dinners — become sources of stress. Parents may pack special foods to avoid confrontation or, in many cases, decline invitations altogether to protect their child from embarrassment or overwhelm. This avoidance can lead to an unintended consequence: isolation. Families miss out on milestones, friendships, and traditions because of the unpredictability surrounding food. The child may feel left out or ashamed, while parents grieve the loss of “normal” family experiences. This social withdrawal can compound the anxiety already present in ARFID and deepen its impact across generations. Emotional Toll on Parents The emotional strain on parents navigating ARFID is significant. Many describe living in a constant state of worry — Will my child get enough nutrients? Will they ever grow out of this? Am I doing something wrong? This worry often spirals into guilt and self-blame, particularly when outside voices dismiss the disorder as mere “picky eating.” In addition, the pressure to “fix” mealtimes can strain marital relationships, creating disagreements over discipline, feeding strategies, or medical decisions. Parents may also feel emotionally depleted, pouring all their energy into managing one child’s needs while inadvertently neglecting themselves or their other children. Without support, this chronic stress can lead to burnout, depression, and disconnection within the family system. The Role of Providers For clinicians, ARFID must be viewed not only as an individual diagnosis but as a family-wide challenge. Effective care requires attention to both the clinical symptoms and the family dynamics that shape recovery. Parent Support: Educating caregivers that ARFID is not their fault, offering psychoeducation, and helping them reframe mealtime struggles as part of the disorder — not a parenting failure. Family-Based Interventions: Coaching families in structured meal support, communication strategies, and gradual exposure work so parents don’t feel powerless. Holistic Care: Involving therapists, dietitians, occupational therapists, and medical providers ensures that the family does not shoulder the weight of treatment alone. When families are validated, supported, and given practical tools, the entire household can begin to heal. Treatment is not only about expanding a child’s food repertoire but also about restoring peace, resilience, and connection at home. Moving Forward ARFID may begin with one individual, but its ripple effects are felt across the entire family system. By addressing both the psychological and relational dimensions, providers can help transform mealtimes from a source of conflict into an opportunity for healing and connection. For those who want to go deeper, we invite you to join our upcoming training on ARFID , where we will explore practical strategies for supporting both clients and their families.
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