Lifestyle makeover for IBD: diet and stress coaching tested alongside meds

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Able to provide written informed consent prior to screening and to comply with the requirements of the study protocol. 2. At least 18 years of age 3. Established diagnosis of CD, UC, or IBD-unspecified 4. Recent (within 6 months) objective evidence of active IBD on colonoscopy or intestinal ultrasound or cross-sectional imaging or elevated inflammatory markers (CRP) 5. Initiating advanced therapy (anti-TNF agents, anti-integrin agents, anti-IL12/23, anti-IL23 agents, S1P receptor modulators, JAK inhibitors) for IBD per usual clinical care within 2 weeks of baseline/randomization, regardless of prior exposure to advanced therapies or disease duration 6. Other non-biologic IBD medications must remain stable during the treatment period and no medication changes are planned with the exception of tapering of corticosteroids. 7. Current disease activity defined as a Harvey Bradshaw index \> 4 at baseline (week 0) for CD subjects or Simple Clinical Colitis Activity Index \> 2 at baseline (week 0) for UC subjects or having had a recent exacerbation being treated with systemic steroids or budesonide. Exclusion Criteria: 1. Inability to provide informed consent or unwilling or unlikely to comply with the requirements of the study. 2. Initiation of advanced therapy for extra-intestinal symptoms alone 3. Known eating disorders 4. Already receiving dietary therapy or stress management interventions 5. Severe untreated psychiatric comorbidity including history of suicidal thoughts 6. Evidence of untreated infection (e.g. Clostridium difficile) 7. Presence of stoma or J-pouch 8. Female subjects who are pregnant, lactating, or intending to become pregnant during the study period 9. On total parental nutrition (TPN) or already following a therapeutic diet for IBD.