Coping with weight changes caused by IBD or its medication

Having Crohn’s disease or ulcerative colitis (IBD) can sometimes change your weight. You might lose weight during a flare, gain weight when taking certain medications, or notice that your body shape changes as you grow up.

These changes can feel confusing or upsetting, especially when your body looks different from your friends' bodies or changes in ways you weren't expecting. Remember, weight changes aren't your fault, and they don't define who you are.

⚖️ Why can IBD affect my weight?

IBD can affect your appetite, digestion and the way your body uses energy. This means your weight might go up or down depending on how you're feeling and how active your IBD is.

Some reasons for weight changes include:

• Flare-ups: Stomach pain, diarrhoea, nausea and a reduced appetite can make it harder to eat enough, which may lead to weight loss.

• Inflammation: Your body may use more energy when it's dealing with inflammation.

• Medication: Some medicines, particularly steroids such as prednisolone, can increase your appetite and cause weight gain or puffiness.

• Feeling better: When your symptoms improve, your appetite may return, and you might regain weight you lost during a flare.

• Growing and puberty: Your body naturally changes shape and weight as you grow, even when your IBD is well controlled.

Everyone's experience is different. Some people lose weight, some gain weight, and others notice very little change.

💊 How can medication change my weight?

Some IBD medications can affect your appetite, weight or body shape.

For example, steroids can make you feel hungrier than usual. They can also cause your body to hold on to more fluid, which may make your face look rounder or your body feel puffier.

These changes can be frustrating, especially if they happen quickly. They aren't necessarily permanent, and some changes improve when your treatment changes or your steroid dose is reduced.

Never stop taking your medication or change your dose on your own. If you're worried about changes to your weight or appearance, talk to your IBD team. They can explain what might be happening and discuss your options.

💙 What if I feel uncomfortable about my body?

It can be difficult when your body changes in ways you didn't choose. You might feel embarrassed, frustrated or worried about what other people think.

You might also compare yourself with friends, feel uncomfortable in certain clothes or wish your body looked the way it did before.

If this sounds familiar, here are some things that might help:

• Be kind to yourself. Your body is dealing with a lot, and it deserves care and patience.

• Focus on how you feel. Think about your energy, strength and how well you're managing your day rather than judging yourself by your weight.

• Wear clothes that feel comfortable. You deserve clothes that fit your body as it is today.

• Take a break from comparisons. Everyone's body develops differently, and social media doesn't always show the full picture.

• Talk to someone you trust. A parent, friend, nurse or counsellor can help you work through difficult feelings.

You don't have to love every change your body goes through. It's okay to have mixed feelings while you learn to adjust.

🥗 How can I look after my body?

When you have IBD, looking after your body means giving it the energy and nutrients it needs, not trying to force your weight in a particular direction.

Here are some ways to support yourself:

• Eat regularly. Try to have meals and snacks throughout the day, especially if your appetite is low.

• Choose foods that work for you. During a flare, you might tolerate some foods better than others. Your dietitian can help you find options that suit your needs.

• Give yourself permission to rest. Fatigue is common with IBD, and you don't have to push through every day.

• Move in ways you enjoy. Walking, swimming, dancing or playing a sport can help you feel good, as long as it suits your energy levels and symptoms.

• Ask for support with food. If eating feels difficult or you're worried about your weight, your IBD team or dietitian can help.

You don't need to skip meals, follow a restrictive diet or exercise to change your weight. Your body needs enough energy to heal, grow and stay strong.

🩺 When should I talk to my IBD team?

Let your healthcare team know if you notice unexpected weight changes, especially if you're losing weight without trying, struggling to eat, feeling unusually tired or experiencing worsening symptoms.

It's also worth speaking to them if medication is affecting your appetite, appearance or confidence.

Your team can check whether your IBD is under control, review your medication and help you get the nutrition you need. You can also ask to speak privately if you're worried about your body image or find it difficult to talk about weight.

You deserve support with how you feel, not just what the scales say.

💬 What if other people comment on my weight?

Comments about your body can hurt, even when people don't mean to be unkind.

You don't owe anyone an explanation about your weight or medication. If someone comments on your appearance, you could say:

• "My body has changed because of my IBD and medication."

• "I'd rather not talk about my weight."

• "I'm focusing on looking after my health."

You can also change the subject or walk away. It's okay to set boundaries about what you're comfortable discussing.

⭐ Remember

IBD and its medications can affect your weight and body shape, but these changes don't define you. Your body is doing its best to manage a complicated condition, and it deserves kindness, nourishment and care.

You don't have to look a certain way to be healthy, confident or worthy of feeling good about yourself.