If you’ve seen Love Lies Bleeding, A24’s new thriller/romance, you might be wondering how Katy O’Brian got so ripped. In the film (which was a huge hit at Sundance and is now in theaters), O’Brian plays Jackie, a bodybuilder who gets involved in an explosive relationship with Lou (Kristen Stewart) after they meet at the gym in a small New Mexico town.
In real life, O’Brian—who is a martial arts instructor and former bodybuilder, in addition to being an actor—lives with Crohn’s disease, an autoimmune condition that typically causes frequent diarrhea, abdominal pain, and intense fatigue, among other really unpleasant symptoms. While she’s generally able to maintain a busy work schedule and lift weights regularly, things went sideways as soon as she started filming Love Lies Bleeding. Her doctor said she needed immediate surgery to remove scar tissue that had formed due to Crohn’s—but taking time for the procedure and the post-op recovery wasn’t exactly an option when she needed to be on set for grueling 12- to 16-hour days and do an additional two to three hours of cardio and lifting every night.
Here’s how O’Brian got her initial diagnosis, what it felt like to bring what she describes as her “dream role” to life, and how she manages the challenges that come with building an acting career while navigating Crohn’s, as told to health and fitness writer Pam Moore.
My symptoms started at least a year before my diagnosis when I suddenly lost 15 pounds. Then I was just so tired, to the point of feeling like I could barely function, especially after a bigger meal. Meanwhile, it wasn’t unusual for me to have diarrhea four times over the course of a 12-hour day of filming. I had no idea what was going on, so I chalked my GI issues and fatigue up to nerves.
Then there were some weird symptoms that you don’t typically think of as being part of Crohn’s: I developed open sores on the corner of my mouth; I started having night sweats; and when I experienced even the slightest surprise, it felt like a bolt of electricity was shooting through my body.
Meanwhile, I continued acting, teaching martial arts, and doing my bodybuilding workouts as usual until March of 2020, when I got really sick. I was throwing up for over a week, and then one morning I woke up and was just vomiting nonstop, even though my stomach was empty.
My wife took me to the hospital, where we found out my intestines had basically swollen shut and were forming scar tissue as a result of what turned out to be Crohn’s. It honestly came as somewhat of a relief, because it explained why I’d been feeling so terrible, and there was a path forward for treatment. At that point I started taking medication and modifying my diet, both of which have made a huge difference in keeping me healthy.
I’ve had very few flare-ups since my 2020 hospitalization. On the rare occasion that I have Crohn’s symptoms, I’m mainly dealing with extreme cramping, diarrhea (sexy, I know), and fatigue.
About two years after my diagnosis, I was cast in my dream role of Jackie, a bisexual bodybuilder in this darkly romantic psychological thriller directed by Rose Glass. It was supposed to be my first day of shooting, and they’d sent me home because I tested positive for COVID. It turned out to be a false positive, but I was already feeling like I ruined the film when my GI doctor called and said I needed surgery immediately. I always get a full medical exam before I start filming, including a physical, blood work, and scans—and my scan revealed some serious issues.
Even though I felt fine, the imaging showed five centimeters worth of scar tissue in my small intestine, which was putting me at major risk for an obstructed bowel. Scar tissue forms adhesions, which can cause your intestines to become twisted and blocked, almost like a garden hose with a kink.
My doctor was shocked that I wasn’t in severe pain. I was freaking out, thinking there was no way I could have surgery and still play Jackie. Then I met with a surgeon who said I could wait until filming was complete to have the surgery, as long as I wasn’t in pain.
After we wrapped up filming, I had to reshoot Ant-Man, and as soon as that was done I underwent an ileocecal resection, which is when they surgically remove part of your small bowel. I had it done laparoscopically, which is a lot less invasive than the alternative, more traditional method, but the recovery wasn’t easy. Everything I read online said it would take several weeks, but it took me about six months for me to get back to normal. Even now, over a year later, I’m still rebuilding my core strength.
Overall, though, I feel so grateful that the surgery went well, my Crohn’s is under control, and that I get to live this life. I certainly don’t consider myself an expert on living with an autoimmune condition, but these are some of the strategies that have helped me manage the physical demands of long days of filming, weight lifting, and doing martial arts.
1. Get super clear on your why.
Working on Love Lies Bleeding meant so much much more to me than just a chance to play a starring role on the big screen. It’s my hope that people in the queer community will watch this movie and see reflections of themselves and their experiences. While the drama centers around Jackie’s romance with Kristin Stewart’s Lou, the movie is about so much more than their sexuality. And I think it’s so important for people to see queer characters with these rich, complex interior lives doing more than just being gay on screen.
I also wanted to be visible as an actor taking on a very physical role while successfully managing Crohn’s. My character, Jackie, is training for a bodybuilding competition, so in addition to filming gym scenes and some pretty intense action scenes, I had to work out for multiple hours every night once I got home.
When I got my diagnosis, the first thing I did was look up actors and martial artists who had Crohn’s. I needed to see other people in my situation to make sure that I could still do the things that gave me joy. Finding those people allowed me to believe I could continue doing what I love. So the idea of being that example for someone else is really motivating to me.
2. Seek out experts you trust.
Navigating a new autoimmune condition is something I was not equipped to handle on my own, and I feel so fortunate to have found a team of experts who always have my back.
My primary care doctor is a DO (doctor of osteopathic medicine), and I love that she takes a holistic approach and really focuses on identifying the root of the problem rather than just treating the symptoms. She was actually the first person who mentioned the possibility that I might have Crohn’s.
I’m also really grateful to have found a surgeon who was willing to take a more conservative approach. She could have scared me into doing the procedure immediately. But instead, she listened to me, and when she heard I wasn’t experiencing any symptoms, she said, “Great. When do you want the surgery?” I cannot explain what a relief that was. She said I could keep working as long as I wasn’t in pain, which gave me the confidence to continue with the movie.
The filmmakers did an amazing job of making sure I was taken care of on set. I had a nutritionist who was responsible for all my meals, which made it easy to eat really healthy and to avoid my trigger foods. I also had a trainer who designed a program that prioritized sustainability; whereas I’d usually do martial arts as my cardio, in addition to lifting, he had me doing lower-intensity cardio and taking one day fully off per week.
3. Listen to your body.
Paying attention to how my body reacts to different things has been a game changer for me. I’ve had to just try different things and see how they affect me. For instance, I have issues with high-fat foods and spicy foods. (Although I have to admit, while I moderate how much spicy food I eat, I’m not ready to give it up completely.) I’ve also found that taking a multivitamin that includes a digestive enzyme before I eat a questionable meal tends to work really well.
I take the same approach to my workouts. I originally got into bodybuilding because I loved how powerful it made me feel. It’s been years since I did a bodybuilding competition, but lifting weights is my go-to for managing stress.
4. Be kind to yourself.
One of the biggest hurdles has been giving myself permission to rest when I’m tired. I wish I could tell everyone who has Crohn’s that if you feel like absolute crap, it’s okay to take a break—and don’t beat yourself up about it.
Before I got my diagnosis, I relied on caffeine to get through my bodybuilding workouts, which I didn’t realize was exacerbating my GI issues. And when I was teaching martial arts at UCLA, my ego was pushing me to try to keep up with the college kids, when I should have been scaling my activity back.
I’ve worked really hard since getting my diagnosis to listen to my body and take a day off or an easy day when I need to. And while that has been challenging, it’s also made me that much more appreciative of the days when I’m feeling good.
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