A foot timidly steps onto a bathroom scale while multiple speech bubbles emerge from underneath.

Stepping on the Scale: How IBD Has Impacted My Weight and Body Image

There are many routine questions asked at my doctor's check-ups and one of those is always: How much do you weigh?

My relationship with my weight has always been a complicated one – whether I've lost it or gained it. Let's jump back a second to pre-diagnosis, the time when I was at my lowest weight.

Before my IBD diagnosis

I was 16 when I noticed I was noticeably skinnier than my peers. I'd always had a tall, wiry frame but this felt different. Even the smallest clothes size didn't fit me and I had no curves. I noticed the eye rolls and questions such as, "Do you even eat?" And I heard people calling me names like anorexic behind my back.

I hated it. I felt like clothes just hung off me but my appetite was great.Like most teenagers, I lived off junk food and it seemed whatever I ate, I didn't gain weight. I wasn't sure if I was a late bloomer but at 18, I still noticed the same problems.

Noticing urgency and fatigue, and period changes

However, I did have other issues. I noticed my toilet trips had changed, I had frequent diarrhea and my periods had, well, vanished. I always felt tired, so much so others caused me lazy.

So a trip to the doctor was in order. It turned out my iron was incredibly low and there was one simple reason I was feeling this way. I wasn't eating enough, apparently.

Why am I so underweight?

"A sausage sandwich is what you need. You need some home-cooked meals. If you start eating more, you'll have more energy and your periods will come back."

But I was eating enough.

By this point I was living at university and lived with a group of girls who watched their weight and went to the gym. I ate all the time, but I took the advice and went home for the weekend. My periods didn't come back.

Commenting on my weight – it's not a compliment

I started to get paranoid. I'm not sure if people deliberately asked, "Have you lost more weight?" to be mean, or if the 2000s was a time where being really skinny was celebrated and people were geniuinely jealous.

I would panic when I went shopping. Would anything fit? Would they have anything in my small size?

"I'm just built that way," I would tell people in my 20s. (Yes, I was still undiagnosed!)

At my lowest weight when finally diagnosed with Crohn's

When I was finally diagnosed with Crohn's disease in 2012, I was at my lowest weight ever. Looking at old photos, I can't believe I thought it was normal at how thin I looked.

When I started IBD treatment, I started to gain a little weight. At least what the scales said, but in my head I was still really skinny.

I would panic if my clothes felt too loose that day. Was I losing weight again? Would I need to change treatments? Was I going to get ill? I was terrified of being ill again.

Gaining weight during pregnancy

The turning point came in pregnancy in my 30s. I gained a lot of weight during pregnancy – around 20 kgs, in fact. I was my heaviest ever and I loved every single second of it.

I was in awe at how my body grew and how healthy and well I looked. I finally loved being weighed at my doctors' appointments and started to develop a real love for my body.

Scared of passing on my IBD

Despite this, my bump was on the small side and the insecurities returned later in pregnancy when I received comments such as, "Your bump is so tiny. Are you sure you're that far along?" After spending my life being the skinny one, I immediately panicked that my baby was too small, too.

What if I'd passed this illness on to him? What if he was malnourished? I had regular growth scans and one showed his weight had dipped. I spent weeks worrying. Of course my skinny body couldn't carry a healthy sized baby, right?

And weight concerns for my child

My son was born one week early at nearly 8 pounds in weight but due to problems with breastfeeding, he quickly lost weight. I can still remember crying in the hospital, convinced it was happening to him what had happened to me. It was hugely triggering after seeing myself lose weight because it was such an anchor I'd lived with for many years, and now it was happening to him.

Yet it was all for nothing. He quickly gained weight and is now almost 4 and has stayed on the 91st percentile for weight (meaning 91 percent of his peers are lighter than him) and very tall. The opposite of what I had imagined and I'm so grateful.

Maintaining a healthy weight

I never lost the baby weight. I'm now the heaviest I've ever been: the combination of being relatively well, postpartum, and taking a drug for my anxiety which is known to cause weight gain.

At first when I was overweight, I didn't really believe it. Surely I couldn't be overweight after spending so many years so underweight?

I knew I could have ate healthier or tried to exercise to lose it, but for me, losing weight was only a symbol of being unwell, rather than a healthy choice.

Always a bit insecure about my body

Whilst I did lose a little, I'm still at the top of my healthy weight range in my BMI. I've gone up 3 dress sizes. But if I'm honest, in my head, I am still the underweight person I used to be.

I still panic when clothes feel loose. Sometimes I buy smaller dress sizes because, in my brain, I am still that underweight girl. (And then feel embarassed when they definitely don't fit!)

It's a really hard thing to change the subconscious feelings in your brain and to accept that weight loss and weight gain can simply be due to food choices or exercise, or even just changes to metabolism – rather than a sign my body is well or unwell.

Having Crohn's has really impacted how I see my body. And whilst I hope this changes soon, I know it won't be easy.

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