In patients with or at risk for inflammatory bowel disease (IBD), the cornerstones of lifestyle medicine include certain dietary patterns with sufficient physical activity, effective stress reduction, proper sleep, and avoidance of environmental toxins. Unfortunately, despite the growing evidence base resulting from high-quality research, and even greater dissemination of knowledge in recent years, significant practice gaps exist that impair implementation of healthy lifestyle change for patients at different stages of this chronic disease. The purpose of this chapter is to present the state-of-art evidence on lifestyle medicine in the management of IBD within the context of pathophysiological drivers and applicable pharmacotherapy. Salient research, knowledge, and most importantly, practice gaps will be identified and potential tactical solutions to narrow or close these practice gaps will be discussed.