Alyssa Ramuscak, RD. Celiac Canada Scientific & Research Analyst, January 18, 2026
The New Year often invites us to think about wellness, such as resetting routines, caring for our bodies, and finding balance at home. For people living with celiac disease, wellness is rarely as simple as starting a new habit or sticking to a plan. Managing a strict, lifelong gluten-free diet is not just a physical task; it can be an emotional and psychological one too.
Emerging research suggests that how we treat ourselves, especially when things are hard, may be just as important as what we eat!
Research consistently shows that quality of life among people with celiac disease is often lower than the general population and, importantly, does not always improve when starting a gluten-free diet(1,2). While strict adherence to the gluten-free diet is essential for managing symptoms and preventing long term health complications, it can also introduce new stressors, such as constant vigilance, social restrictions, fear of cross-contamination, and feelings of isolation.
Some studies suggest that adaptive coping strategies, such as problem-solving, planning, and positive reframing are associated with more positive attitudes towards the gluten-free diet, greater perceived control, and stronger intentions to adhere (3). While stricter adherence is linked to better health outcomes (4–6), we still lack evidence-based strategies that support both adherence and the psychological experience of living with celiac disease.
This is where concepts like self-regulation and self-compassion may be important!
Self-regulation refers to the process by which people manage their own behaviour to achieve desired goals (7). In chronic conditions, like celiac disease, it is not a one-time skill, rather it is an ongoing, lifetime process.
Self-regulation includes:
An important related concept to self-regulation is self-regulatory efficacy. Self-regulatory efficacy is your confidence in your ability to manage your behaviours (8). Feeling capable, rather than constantly overwhelmed, can make a meaningful difference in daily adherence.
Terry and Leary (2011) describe self-compassion as a means of treating yourself with the same kindness, care, and understanding you would offer to a loved one (9). It includes key elements:
Higher self-compassion has been associated with better mental health and less intense negative feelings towards stressful events (9). Self-compassion may be important in celiac disease management where accidental gluten exposures or uncertainty around social events can happen in light of your best efforts to maintaining a strict gluten-free diet.
A study by Dowd and Jung (2017) was the first to directly examine self-compassion in relation to gluten-free diet adherence and quality of life in adults with celiac disease (10).
In their prospective study of 200 North American adults, participants completed online questionnaires at baseline and one month later. In these questionnaires, the researchers assessed gluten-free diet adherence (including accidental and intentional gluten intake), self-compassion, self-regulatory efficacy (confidence in managing the diet), concurrent self-regulatory efficacy (confidence in managing a gluten-free diet alongside other valued life goals), and celiac-specific quality of life.
The authors found that higher self-compassion at baseline predicted stricter gluten-free diet adherence and better quality of life one month later. They also found that self-compassion also worked indirectly by improving confidence in self-regulation and confidence in balancing gluten-free diet demands with other life goals. In other words, self-compassion didn’t reduce adherence but rather supported it!
The authors did note limitations, including reliance on self-reported data and lower levels of non-adherence in the sample, meaning results may not fully reflect those who struggle most with adherence.
Overall, the findings offer valuable insights into how psychological strategies could support both health and well-being of individuals living with celiac disease.
While there are currently no celiac-specific interventions designed to build self-regulatory efficacy or self-compassion, research from chronic disease management offers practical starting points (9).
To support self-regulation:
For building self-compassion, try these small but meaningful practices at home:
At home, wellness doesn’t mean having to do everything perfectly. Wellness is working towards systems and routines that protect your health, and treating yourself with kindness, even on the hardest of days.
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