Body Image and IBD

Loving your body while suffering from IBD can be hard. Sometimes, we are prone to wonder how it is possible for us to love a body that seems to “fail” us when it comes to our health.

Many IBD patients have been there – that sudden lack of control over symptoms and subsequent fear of an impending accident. And possibly worst, the shame and guilt that we can feel following an unexpected IBD episode. With symptomology that can present itself so abruptly and without warning, it is no surprise that our personal body image can suffer as a result.

Beyond the rollercoaster of IBD symptoms, side effects from different treatment options can leave us feeling less than confident. Scarring from surgeries or the presence of an ostomy bag, weight fluctuations associated with medication, skin problems, or fatigue – each of these factors can deal a significant hit to our body satisfaction.

While much of patient care regarding IBD is focused on the physical, mental health complications carry just as significant a risk and burden as physical symptoms. In particular, body dissatisfaction is associated with an increased risk of depression, anxiety, low self-esteem, disordered eating, and poor self-care habits (Saha et al., 2015; Cushman, 2021; Sharon, 2015). These mental health complications can then reflect in our physical health and personal relationships.

Despite its significant influence on quality of life, body image is rarely discussed within populations experiencing IBD. Several factors associated with IBD can lead to negative body image perceptions including age of diagnosis, duration of steroid exposure, perceived burden of symptoms, active disease, and certain extraintestinal manifestations of IBD (particularly dermatological symptoms) (Beese et al., 2019).

Improving outcomes for patients with IBD and poor body image begins with a conversation about the psychological toll of IBD. Often, we enter the healthcare setting to find the focus placed solely on controlling physical symptoms. Of course, management of physical symptoms is important; however, the influence of these physical symptoms on mental health proves to be a significant conversation as well. Resources for both physical and mental wellbeing need to be accessible to IBD patients in order to provide more holistic treatment.

In addition to promoting dialogue about mental health and IBD, we need to focus on erasing perceptions of shame and embarrassment surrounding IBD symptomology. Lack of control over symptoms or unexpected incidents should not be attributed to a personal shortcoming of our body – no one should feel humiliated for a condition in which they have no control. Now this is much easier said than done – the stares, hushed whispers or laughs and perceived judgement from others may be beyond our area of control. However, what is in our control is the manner in which we react – rather than letting these situations degrade our worth we have to continue moving forward and raising awareness with the hope of more universal acceptance in the future.

And ultimately, improving perceptions of body image within the IBD community means reaching a realization that IBD does not make our body “broken” or “lesser” than that of someone without IBD. Our physical scars, our personal battles, and our perseverance through this disease is no way define us as damaged or inferior. If anything, each IBD warrior’s personal journey shapes them into an individual with more strength, more compassion, and more understanding.

As an IBD community, I do not think we should prescribe to the societal standards of beauty pushed upon us by the media or our peers. Each of us has the opportunity to define what beauty means to us personally and the manner in which we choose to perceive our body image. Our resilience in living with IBD whether, through our scars, our ostomy, or any other aspect proves our worth more than any societally prescribed definition of beauty.

References

Beese, Sophie Elizabeth, Isobel Marion Harris, Janine Dretzke, and David Moore. “Body image dissatisfaction in patients with inflammatory bowel disease: a systematic review.” BMJ open gastroenterology 6, no. 1 (2019).

Cushman, G., Stolz, M. G., Shih, S., Listernick, Z., Talmadge, C., Gold, B. D., & Reed, B. (2021). Age, Disease Symptoms, and Depression are Associated with Body Image Dissatisfaction in Newly Diagnosed Pediatric Inflammatory Bowel Disease. Journal of pediatric gastroenterology and nutrition, 72(3), e57.Saha, S., Zhao, Y.Q., Shah, S.A., Esposti, S.D., Lidofsky, S., Bright, R., Law, M., Moniz, H.

Jedel, Sharon, Megan M. Hood, and Ali Keshavarzian. “Getting personal: a review of sexual functioning, body image, and their impact on quality of life in patients with inflammatory bowel disease.” Inflammatory bowel diseases 21, no. 4 (2015): 923-938.

Samad, Z., Merrick, M. and Sands, B.E., (2015). Body image dissatisfaction in patients with inflammatory bowel disease. Inflammatory Bowel Diseases, 21(2), 345-352.

• About The Author

Catherine is 23 year old Crohn’s patient from Denver, Colorado. She recently graduated from the University of Kansas where she majored in human biology and anthropology. She also ran on the cross country/track and field team while in college and was diagnosed with Crohn’s during this time. She is passionate about sports medicine and finding ways to integrate physical activity into the lives of individuals with IBD. She is pursuing medical school and hopes to become a sports medicine physician or gastroenterologist. She loves trail running, hiking, camping and spending time with family/friends.