How Does Crohn’s Disease Affect Body Image?

The symptoms and effects of Crohn’s disease aren’t just tough to deal with physically. They can change how you feel about your body — and in turn, how you feel about yourself.

“These sorts of concerns are very real and common,” says GI psychologist Megan Riehl, PsyD, an associate professor of medicine at the University of Michigan in Ann Arbor and board member of the Crohn’s & Colitis Foundation.

What’s more, they can have far-reaching effects for your mental health and your relationships. But with some effort, it’s possible to shift your perspective. Here’s a look at the ways that Crohn’s might be impacting your body image and expert-recommended strategies that can help you feel more confident.

Crohn’s can put your body through some major physical changes. These can stem both from your actual disease as well as your treatments, says Arushi Kohli, MD, a gastroenterologist and director of the intestinal ultrasound program at Tufts Medical Center in Boston.

• Gastrointestinal symptoms like gas, bloating, nausea, diarrhea, and accidents or stool leaking
• Extraintestinal (outside the intestines) symptoms like skin rashes, ulcers, or stiff joints that limit your activity
• Weight loss from malnutrition or restrictive diets
• Fistulas or abscesses in your perianal or genital area
• Steroid-related side effects, like weight gain, acne, or so-called “moon face”
• Surgery-related changes like scarring, stomas, or needing an ostomy

A lot of different emotions can come up when your body no longer looks or acts like you expect it to, even if those changes or symptoms are temporary. “People might have embarrassment or shame, feel self-conscious, or feel less confident or have a lower self-worth. And that can drive things like depression and anxiety,” says Taryn Lores, PhD, a health and clinical psychologist at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai in New York City.

No one is able to fully control their Crohn’s at all times, but you can take steps to build a more accepting relationship with your body. Here’s what our experts recommend.

• Clarify your feelings. Try to get specific in terms of what you dislike about your body and the factors that seem to be playing a role. When you can identify specific issues, you may be able to talk with your care team about specific solutions, Dr. Riehl says. For instance, if you’re struggling to keep weight on, a registered dietitian specializing in Crohn’s can help you come up with a healthy meal plan with foods you can tolerate.
• Be open with others. Let those you trust know how you’re feeling, especially with regards to relationships and intimacy. “Just saying, ‘I’m feeling X about my body right now and I would feel most comfortable doing Y [can help],’” Riehl says.
• Be as active as you can. Moving your body helps you appreciate it for what it can do — whether that’s meeting a friend for tennis, taking a stroll after dinner, or just doing some gentle yoga in your living room, Riehl says. Plus, exercise is a proven mood- and self esteem–booster.

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• Go beyond the physical. Show some appreciation for the many great things about you that aren’t related to your appearance, Dr. Lores says. Maybe you’re a loyal friend, you can always make someone laugh, or you can make any animal your friend. Whatever makes you you, celebrate it.
• Connect with others who get it. Consider attending a Crohn’s disease support group or asking your doctor if they have other patients who are further along in their Crohn’s journeys and might be willing to chat with you. “The more community you can find, the better you’ll feel,” Dr. Kohli says.
• Get support from a therapist. If you’re struggling to manage your emotions about your body on your own, a health psychologist who works with people with Crohn’s disease or IBD can help you find ways to cope.
• Be kind to yourself. When the negative self-talk starts up, ask yourself whether you’d say these kinds of things to a family member or friend. If the answer is no, try to give yourself the same compassion you’d give to someone else, Lores says.