Have you ever looked at a restaurant menu and felt like you were looking at a list of potential landmines? If you have, you’re not alone, and more importantly, you aren’t being difficult.

This year, some heavy-hitting scientific journals have shared data behind what we’ve known in the inflammatory bowel disease (IBD) community for years: the mental toll of deciding what to eat can be as taxing as the flare itself.

With it being Eating Disorders Awareness Week, I wanted to talk about some recent research article that centre around how we fuel our bodies while managing Crohn’s and Colitis. 💕

The Jargon Buster: Food – Related Quality of Life (FRQoL)

Under this one heading, two important publications have come out this year that validate the emotional side of eating. Here is the split of what was said and why it matters to you:

The Nature Reviews Commentary: A high-profile piece in Nature Reviews Gastroenterology & Hepatology has called for a major shift in how doctors talk to us about food. They argue that medical guidelines need to stop just looking at what a diet does to our gut and start looking at what it does to our lives.

• Why it matters: It is an official recognition that a diet that fixes your inflammation but leaves you too scared to leave the house is not a successful treatment.

The BMJ Open Study (The 79% Statistic): This stands for Food-Related Quality of Life, and it is a 29-item questionnaire designed to measure the hidden impact IBD has on your emotional and social relationship with food. Rather than just looking at what you eat, it tracks things like your anxiety around meals and the mental toll of restrictive eating. By using this tool to measure patient perspectives, researchers found that 79% of people with Crohn’s disease experience significant anxiety when eating away from home. I know, not new news to us!

• Why it matters: This proves that the stress of policing your own plate – the fear of pain, the search for a toilet, and the social isolation of not being able to share a normal meal – is a distinct clinical symptom. It is now something that can be measured and, hopefully, better supported by our clinical teams.

When fasting becomes a tool: The Cell Reports study

Adding to this conversation is a new study regarding Time-Restricted Feeding (TRF). You might know this as intermittent fasting.

The Details: This was a randomised controlled study involving 35 adults with Crohn’s disease. It’s a relatively small group, so while the results are exciting, we have to remember it is a starting point, not a universal rule for everyone.

The researchers found that an 8-hour eating window (fasting for the other 16 hours) helped reduce symptomatic disease activity by 40% over 12 weeks. It also lowered inflammation markers like Leptin and helped reduce visceral fat – the deep fat around your organs that can drive inflammation.

The thin line: IBD and Eating Disorders Awareness

While the fasting study is interesting for managing inflammation, we have to talk about the elephant in the room for Eating Disorders Awareness Week.

When you have IBD, your relationship with food is often born out of trauma. If a certain food caused you the worst pain of your life, or led to an emergency hospital admission, it’s natural to avoid it. In the medical world, this can sometimes cross into ARFID (Avoidant/Restrictive Food Intake Disorder).

The difference between a therapeutic diet, like a low fibre or low residue diet and disordered eating is a very thin line when you are trying to survive a flare.

This new research into FRQoL is so important because it moves us away from the just eat this mentality and starts asking, how can we help you feel safe around food again? It validates that for many of us, the trauma of the disease has changed the way our brain perceives a meal.

How are you doing with it?

If you find yourself staring at the fridge with a sense of dread, please know that it isn’t a failure of willpower. It is a recognised part of living with a chronic condition.

We need more than just dietitians; we need support that understands that for us, a meal is never just a meal.

Please know that you are doing a great job navigating a very messy path. 💜