How to Maintain a Healthy Relationship With Food When You Have IBD

By helitra·November 11, 2026·7 min read

Because food can trigger symptoms of an inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis, it’s not surprising that disordered eating is often a complication of the condition. Even people with IBD who are in remission and have no medical reason to restrict what they eat may do it anyway, to the extent that it’s detrimental to their mental health.

If this rings true for you, it’s important to understand that mental and emotional reactions to eating can be managed. Here, find out what you can do to maintain a healthy relationship with food when you have IBD.

The Link Between IBD and Disordered Eating

Everyone who lives with IBD goes through periods of active inflammation that cause an array of several gastrointestinal (GI) symptoms, known as flares. Between flares, when in remission, people with IBD are usually able to return to a regular diet. But even when your doctor gives you the okay to ease up on dietary restrictions, it’s not always easy to do.

“Often, patients who start working with me are still restricting their diet, even after a decade of remission,” says Alyse Bedell, PhD, the director of the psychogastroenterology program at the University of Chicago.

What’s more, one food restriction often leads to another. “What comes with IBD is a lack of control,” Dr. Bedell says. Because people with IBD tend to fear eating something that may trigger a flare, it can be tempting to use food as a way to control the condition, she says.

This falls into disordered eating, a broad term used to describe a problematic eating behavior or attitude toward food, and it occurs on a spectrum. As you move up the spectrum, food restriction becomes more severe.

It’s possible for IBD-associated disordered eating to meet the criteria for an eating disorder, such as anorexia, which is characterized by food intake restrictions, body image disruptions, and a fear of food or gaining weight. But it’s more common to develop avoidant eating behaviors with IBD, even in remission, according to research – and at the extreme end of that spectrum is a condition called avoidant restrictive food intake disorder (ARFID).

“ARFID isn’t tied to concerns about weight or shape but, rather, the fear of the consequences of eating certain foods, leading to significant restriction, distress, and impairment,” Bedell says.

How the Brain and Gut Respond to Anxiety Around Food

Reestablishing a healthy relationship with food requires thinking differently about what you eat as well as resolving your fear and anxiety around it. First, it’s important to understand that people who develop GI issues, including IBD, often experience one or more of three states that can affect their relationship with food.

Hypervigilance, meaning being extremely sensitive to and focused on sensations in the body. This is connected to the anxiety people with IBD experience in anticipation of symptoms.
Catastrophizing, or imagining the worst-case scenario. “These thoughts go through their head quickly,” says Ali Navidi, PsyD, a clinical psychologist in Burke, Virginia. Catastrophizing is a kind of automatic negative thought pattern, which is typically involuntary.
Visceral hypersensitivity, in which the brain takes the sensations in your digestive system organs and amplifies and distorts them. For instance, what starts as a feeling of digestion gets amplified and distorted into pain, says Dr. Navidi.

How to Think Positively About Food and Eating With IBD

Breaking the pattern of those three states is often easier said than done, but there are a few approaches you can take to help banish negative thoughts about food.

Create a Support Team of Specialists

Besides your gastroenterologist, other experts can help you manage the physical and mental aspects of IBD. For example, a dietitian who understands the condition can help you figure out which foods to restrict or avoid during flares. And, given the close relationship between the gut and the brain, it can be highly beneficial to work with a mental health professional to help you manage depressive and anxious thoughts associated with IBD, says Navidi.

Therapists can use cognitive behavioral therapy (CBT), a type of talk therapy that involves changing negative thought patterns and unhelpful behaviors. “CBT teaches [someone] how to identify dysfunctional patterns of thinking like hypervigilance and catastrophizing, so they can make changes in those patterns,” says Navidi. CBT has also been shown to help calm disorders of gut-brain interaction like irritable bowel syndrome (IBS), which often co-occur with IBD and also feature visceral hypersensitivity.

Some therapists also use clinical hypnosis. With this type of therapy, you’ll learn how to go into a trancelike state, which increases your levels of absorption and suggestibility. “When you’re in that state, you have more access to the mind-body connection, and you can turn down the volume on [feelings of visceral] hypersensitivity,” says Navidi.

There are even self-directed smartphone apps that offer gut-directed hypnotherapy, like Nerva.

Use the Traffic Light Approach

To rethink how you view specific foods, try dividing them into three categories that correspond to the meanings of traffic signal colors: Green-light foods are those you regard as safe to eat, as they don’t cause fear or anxiety. Yellow-light foods are those you tend to consume with caution, because they sometimes trigger symptoms. Red-light foods you may associate with symptoms and flares, and so you steer clear of them altogether.

But, working with a GI dietitian, says Bedell, you may be able to transform many of the yellow- and red-light foods into green-light foods. This way, she says, “What you eat will largely be based on preference, not fear.”

Be Patient

Gradually expose yourself to foods you’ve been avoiding. The first few times you eat one of these foods, it may trigger your body’s stress response, says Bedell. But, over time, your brain will learn that the food isn’t dangerous, and you’ll be able to enjoy it again.

Keep a Journal

As you add foods back into your diet, write down your experience eating each one. Make note of whether it triggered symptoms or a flare, for example, and in what ways. Be as detailed as possible. “What you measure, you can manage,” Navidi says.

Join a Support Group

Whether in-person or virtual, regular meet-ups with others dealing with IBD can play a valuable role in managing the condition. Your care team may be able to point you toward a support group that aligns with your experience; the Crohn’s & Colitis Foundation website also features a page on their website that connects people to support groups throughout the United States and in Canada.

The Takeaway

It’s not uncommon for people with an inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis, to develop disordered eating habits, even in remission.
An IBD can change your relationship to food and cause you to experience hypervigilance, catastrophizing, or visceral (organ) hypersensitivity as a result.
But there are a number of ways to treat unhealthy attitudes and behaviors around food, including cognitive behavioral therapy, clinical hypnosis, and gradual exposure to foods.

EDITORIAL SOURCES

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Resources

Di Giorgio F et al. A Narrative Review on Eating Disorders and Disordered Eating in Inflammatory Bowel Diseases: Need for Increased Awareness. Dietetics. April 24, 2023.
Veraza DI et al. Perceived Utility of Cognitive Behavioral Therapy in People With Bowel Disorders of Gut-Brain Interaction. Neurogastroenterology & Motility. March 8, 2026.

Meet Our Experts

See Our Editorial Policy Meet Our Health Expert Network

Stephanie Albers, PhD

Medical Reviewer

Stephanie Albers, PhD, is an eating disorder clinical assessment program manager for Project Heal and a size-inclusive therapist for Libra Virtual Care. She maintains clinical lice…

See full bio

Karen Asp

Author

Karen Asp is an award-winning journalist who covers fitness, health, nutrition, pets, and travel. A former contributing editor for Woman’s Day, she writes regularly for numerous pu…