Selena Gomez is getting real about her health struggles.

In November, the actress, 32, clapped back at online commenters who said that she was hiding her body during her Emilia Pérez premiere. In response, Sel shared that she actually has a disorder called SIBO, a.k.a. small intestinal bacterial overgrowth.

“This makes me sick,” she wrote in a since-deleted comment, per Elle. “I have [SIBO] in my small intestine. It flares up. I don’t care that I don’t look like a stick figure. I don’t have that body. End of story. No I am NOT a victim. I’m just human.”

SIBO can cause abdominal pain, bloating, constipation, fatigue, and more according to the Cleveland Clinic.

But that isn’t the only condition that Selena struggles with. She has also been living with lupus, an autoimmune disease, for more than a decade. Over the years, she’s gotten candid about her experience with the chronic illness, from undergoing a kidney transplant and chemotherapy to how it’s impacted her mental health.

Ahead, here’s everything Selena has shared about her lupus diagnosis and health journey:

What is lupus?

Lupus is an autoimmune disease that causes your body’s immune system to attack your own tissues and organs, which can cause painful inflammation and swelling, per the Mayo Clinic. The inflammation can affect many systems throughout the body, including joints, skin, kidneys, blood cells, brain, heart, and even the lungs. While there is no known cure for lupus, there are a variety of treatments patients can undergo, per the Mayo Clinic.

While Selena may be the first person you think of with this health condition, 1.5 million Americans, and at least five million people worldwide, have a form of lupus, The Lupus Foundation of America estimates.

Selena was diagnosed with lupus in 2013.

In her October 2015 cover story with Billboard, Selena first revealed her lupus diagnosis. “I was diagnosed with lupus, and I’ve been through chemotherapy. That’s what my break was really about. I could’ve had a stroke,” she told the publication of her time spent out of the spotlight (which sparked rumors about her being admitted to a rehabilitation facility for addiction). “I wanted so badly to say, ‘You guys have no idea. I’m in chemotherapy… I locked myself away until I was confident and comfortable again.”

A year later, in April 2016, Selena further opened up about this difficult time in her life during a cover story interview with GQ, which stated that she’d been diagnosed in 2013. “I got diagnosed with lupus. My mom had a very public miscarriage. So I had to cancel my tour. I needed time to just be okay,” she told the magazine.

Before her diagnosis, Selena would often continue to work, despite having symptoms. “I would get fevers, headaches. I would get fatigue. But I always just kept going,” she told TODAY in 2017. “I kind of ignored it, to be honest…I don’t think I made the right decisions because I didn’t accept it. And that’s extremely selfish, and at the same time, really just unnecessary. I’m not really proud of that.”

She went to a rehabilitation facility for chemotherapy.

After her lupus diagnosis, the “Lose You To Love Me” singer went to Meadows, an Arizona rehab facility, to receive chemotherapy treatments, according to GQ. At the time, her lupus diagnosis was not public knowledge, so the online rumor mill exploded with stories claiming the pop star was in rehab for substance abuse.

It was also the first time Selena sought treatment for mental health, according to her 2021 interview with ELLE. “I don’t even know what they really believed I was doing—drugs, alcohol, running around, partying. The narrative was so nasty,” the Spring Breakers star said.

She took to Instagram to take her power back. “I want to claim back my name,” Selena wrote in a caption, at the time, per Elle. “Yes, I went away. Yes, I struggle with mental health. I’ve been depressed, and I’ve had anxiety.”

Selena underwent a kidney transplant in 2017.

That summer, Selena received a kidney transplant from her friend and How I Met Your Father actress Francia Raisa. A few months later, in September, she opened up about the life-saving surgery in a touching Instagram tribute.

“I’m very aware some of my fans had noticed I was laying low for part of the summer and questioning why I wasn’t promoting my new music, which I was extremely proud of. So I found out I needed to get a kidney transplant due to my Lupus and was recovering. It was what I needed to do for my overall health,” she captioned the post. “I want to publicly thank my family and incredible team of doctors for everything they have done for me prior to and post-surgery. And finally, there aren’t words to describe how I can possibly thank my beautiful friend Francia Raisa. She gave me the ultimate gift and sacrifice by donating her kidney to me. I am incredibly blessed. I love you so much sis. Lupus continues to be very misunderstood but progress is being made.

A month later, Selena and Francia sat down with Savannah Guthrie for a joint interview about their kidney transplant experience. “I got to the point where it was really life or death,” Selena said, adding that Francia saved her life.

She also sought therapy for panic attacks and depression related to her health struggles.

The “Calm Down” singer was diagnosed with bipolar disorder in 2018, she shared with Elle. “I felt a huge weight lifted off me when I found out,” Selena said. “I could take a deep breath and go, ‘Okay, that explains so much.’”

She received treatment for the panic attacks and depression she’s faced as a result of her illness, she shared with People in 2019. She even said that increased anxiety and panic attacks can be side effects of lupus.

“I’ve had a lot of issues with depression and anxiety, and I’ve been very vocal about it, but it’s not something I feel I’ll ever overcome,” she shared in a 2018 interview with Harper’s Bazaar. “There won’t be a day when I’m like, ‘Here I am in a pretty dress—I won!’ I think it’s a battle I’m gonna have to face for the rest of my life, and I’m okay with that because I know that I’m choosing myself over anything else.”

In 2020, Selena spoke about how new medication and therapy were helping her to feel more stable. “I’m on the proper medication that I need to be on, even as far as my mental health. I fully believe in just making sure you check in with your doctors or therapist,” she shared on NPR. “That’s forever. That’s something I will have to continue to work on. Yes, I don’t think I just magically feel better. I have days where it is hard for me to get out of bed, or I have major anxiety attacks. All of that still happens.”

Selena’s mental health is a constant process for her. She’s been to four mental health treatment facilities in total, she told Rolling Stone, and has been diagnosed with bipolar disorder.

“I will always be working on my mental health, and I will always evolve,” she told Today in May 2024. “I’m not better or worse than anyone. I’m simply just a person living and surviving every day.”

Because of her bipolar disorder, the actress cannot carry her own children. “I haven’t ever said this…but I unfortunately can’t carry my own children,” she told Vanity Fair in a cover story published September 9. “I have a lot of medical issues that would put my life and the baby’s in jeopardy. That was something I had to grieve for a while.”

Selena didn’t get into details about what those medical issues are, but she previously told Rolling Stone that she may not be able to have children because of medications she takes to manage her bipolar disorder.

She had a flare-up in 2020.

Although Selena’s kidney transplant helped move her lupus into remission for some time, she had another painful bout in 2020.

“I haven’t felt it since I was younger,” she said in her 2022 documentary, Selena Gomez: My Mind and Me, while crying. “Now it just hurts in the morning. When I wake up, I immediately start crying because it hurts—like everything.”

Her lupus is now in remission.

Sel’s lupus is now in remission, she shared with Time in May 2024. Additionally, her blood pressure is stable and her transplanted kidney is working well. (Remission means that your symptoms have gone away for an extended time period, according to the Lupus Foundation.)

She also seems to have a healthy perspective on everything she’s been through, noting that the condition helps her relate to fans. When she was 18, Selena visited a boy in the hospital who wouldn’t look her in the eye until he discovered that she also had lupus, she shared.

“It was so sweet,” she said. “In a weird way, I turned the bad things into a good thing.”

Selena has talked openly about how the treatments affect her body.

Selena has undergone multiple lupus treatments, which have taken a toll on her body. In a TikTok, Selena’s hands visibly shook as she did a makeup tutorial. She shared in a comment that this was because of her medication, per E! News.

The Texas native also shared that she deals with inflammation and weight fluctuations in a TikTok live stream that was reposted on X (formerly Twitter). Selena explained that her lupus medication causes her to hold on to a lot of water weight, which is a normal side effect.

“I just want people to know that you’re beautiful and you’re wonderful,” Selena shared. “Yeah, maybe we have days where we feel like sh*t, but I would much rather be healthy and take care of myself. My medications are important, and I believe they are what helps me.”

Selena has been open about accepting her body, sharing in a 2022 TikTok Story reposted to Instagram, “Honestly, I don’t care about my weight because people bitch about it anyway. ‘You’re too small,’ ‘you’re too big,’ ‘that doesn’t fit.’ ‘Meh meh meh meh.'”

“B*tch, I am perfect the way I am,” she added. “Moral of the story? Bye.”

In January 2024, Selena publicly celebrated her body on Instagram. First, she shared an Instagram Story featuring a snap from 2013 of her wearing a zebra-print bikini with the caption, “Today I realized I will never look like this again…” But then, Sel shared an updated photo of herself in a black and white swimsuit. “I’m not perfect, but I am proud to be who I am… Sometimes I forget it’s ok to be me,” she wrote over the photo.

Selena has also denied getting plastic surgery. In July, she hopped in the comments of a TikTok video where a creator (who works as a PA in a plastic surgery office) said she didn’t want to speculate about work that Selena had done due to her medical history.

“Honestly, I hate this,” Selena wrote in the caption. “I was on stripes because of [a] flare-up.” (It’s not clear what “stripes” means, but Selena seems to be referring to steroid medication.) Selena then wrote, “I have Botox. That’s it. Leave me alone.”

She’s proud of her surgery scars.

“When I got my kidney transplant, I remember it being very difficult at first showing my scar,” Selena wrote in an Instagram post, shared in October 2020. “I didn’t want it to be in photos, so I wore things that would cover it up. Now, more than ever, I feel confident in who I am and what I went through…and I’m proud of that.”

She’s made her beauty products accessible.

Selena’s cosmetics brand Rare Beauty, is a hit, with her viral blushes consistently selling out at retailers like Sephora and Ulta. But it’s also a personal mission for Selena: It was important for the products to have accessible packaging, given that she takes a drug for lupus which can cause her hands to shake, she told Time.

“Because of my personal experience, I’ve always been drawn to packaging that’s easy to open and close, hold, and apply,” Selena said in a statement on the company’s website.