The traditional look of celiac disease was an underweight person. However, a large minority (39%) are now found to be overweight at diagnosis.
A woman with a history of struggling to lose weight is diagnosed with celiac disease. After starting the gluten-free diet she loses 50 lbs in less than a year…seemingly without effort. A middle-aged man who has never had issues with his weight is diagnosed with celiac disease, adopts the gluten-free diet and begins to pack on pounds and doesn't know why. A young man loses over 20 lbs in less than 3 months and reaches his ideal weight after going gluten-free.
These are true stories – in fact the last one was mine.
Some people gain weight before diagnosis of celiac disease and lose it after adopting a gluten-free diet. Others gain weight after diagnosis.
This begs an obvious question. Why do some people gain weight from celiac disease before starting the gluten-free diet and some after?
The simple answer is because celiac disease makes your body malnourished and sick and depending on the type of sickness and the nutrients that are missing, weight gain will result.
Overweight Yet Malnourished
Here's how it works. In celiac disease, intestinal damage occurs that interferes with digestion and absorption of nutrients.
This does not mean you absorb no nutrients at all. You frequently have a situation where you absorb some nutrients just fine and others hardly at all. For example,you might absorb vitamin C, but not B12. So, you eat what you think is a balanced diet, but you only absorb certain things. That makes you hungry for the missing nutrients…setting up cravings. Your body needs those missing nutrients and wants them.
Undigested nutrients that are not absorbed are then dumped into the colon where bacteria ferment them into short chain fatty acids which are then absorbed into the body and stored as fat because the body doesn't need all that energy. For example, if unabsorbed proteins are fermented in the colon, the body will get the protein for use in muscle repair or enzyme production or hormones. Instead it will receive energy, in the form of fatty acids, in greater amounts than the body needs.
In effect, you have a situation where you are overweight, yet malnourished. You are sick, but the sickness is masked by a body that looks like it is overfed.
What happens if you force your body to exercise when you are malnourished?
Exercise will become exhausting if you are not absorbing energy from carbohydrates, thiamin needed for metabolism, proteins for muscle building and repair, or the minerals needed for strength like calcium, magnesium potassium and selenium, or energy is not delivered because red blood cells are unhealthy. Your workouts will be unproductive. You will use up nutrient stores that your body desperately needs, faster than your body can replenish them, so your body will shift into starvation mode and your metabolism will decrease to conserve nutrients. Injuries may occur as nutrient starved parts malfunction. Illnesses and infections will increase. Once you stop exercising, you will gain weight because you will no longer be burning up fatty acids that are still being produced by bacteria in the colon.
What happens if you limit your calories to lose weight when you are malnourished?
Dieting, like exercise, exacerbates malnutrition. As you try to limit foods in order to lose weight, you set yourself up to be hungry all the time. When your will fails, and you increase your food intake, you will gain weight because your metabolism has slowed. If your will is very strong, you may possibly create a situation where tissues, organs or entire body systems begin to malfunction.
Edema - a.k.a. Fluid Retention
Edema is another factor in celiac disease that leads to weight gain. Gluten causes inflammation that can be localized to the intestine or body-wide. Inflammation leads to edema, also called fluid retention. Edema, is characterized by excess extracellular fluid volume and marked by weight gain, coarsening of facial features, thickening of subcutaneous skin and swelling of lower limbs in the case of vitamin C deficiency. In non-celiac gluten sensitivity reactions, edema results from direct damage to tissues by gluten and immune system reaction to get rid of it. In celiac disease, edema results from inflammatory response and nutrient deficiencies of copper, EPA, protein, thiamin, vitamin C and vitamin K.(Recognizing Celiac Disease p. 176) The intestines can become grossly swollen, leading to an enlarged abdomen or pot-belly look.
Edema can easily be mistaken for fat. A person will look fleshy, but this type of weight gain is neither fat nor muscle. It is retained fluid due to ongoing inflammation and/or nutrient deficiencies.
Gluten-free dieters who lose 7-10 pounds in the first week or two, lose the weight because the swelling decreases, not because fat is being burned. As the inflammation decreases, the fluid is released…your jawline becomes defined and your clothes fit better.
What You Should Do
If you have cravings that drive you to overeat - or if you have a balanced diet, your portion sizes are appropriate, yet you are gaining or cannot lose weight, visit the Glutenfreeworks.com Symptom Guide. Look up your symptoms to see if they correspond with celiac disease. If they do, then ask your physician to test you for celiac disease. Weight loss may be as easy as eliminating gluten from your diet.
If you have gained weight after starting the gluten-free diet and you are not overeating or you have cravings, then you may wish to take a "nutrient deficiency identification and correction" approach to your diet. Correcting nutrient deficiencies heals your body. As your body heals, it begins to function properly and your weight normalizes.
Identify your health symptoms and determine which nutrients you might be lacking. Then add more of the foods high in those nutrients to your diet. Be sure to keep track of your total caloric intake, so as not to overeat.
The Gluten Free Works Health Recovery Center is a reference that can help you identify and correct missing nutrients. It lists hundreds of health issues related to celiac disease, which nutrient deficiencies cause them, and dietary sources highest in those nutrients. While the website is not only focused on weight loss, people find when they look up their symptoms and start adding the missing nutrients to their diet, their cravings go away and they lose weight (or gain it if they were too thin).
This strategy works. I know a woman who lost 110 lbs in 10 months, and was able to be taken off bipolar and schizophrenia medications - just by identifying her symptoms in the book and correcting the nutrient deficiencies causing them. She removed the source of her problems - gluten - and as her body received the nutrients it needed and became healthy, the weight melted away.
If you are diagnosed with celiac disease, ask your doctor to test you for vitamins A,D,E,K, B12, folic acid and minerals calcium, phosphorus, iron as the NIH recommends. Pay close attention to where you fall in the range on the test results. What is low, but acceptable, for some may be too low for you. I saw this in a man who suffered from anemia symptoms, even though his iron levels were within acceptable range for most people.
Stop the Cravings. If you crave gluten, you are craving the amino acid, glutamine, which is richly present in gluten. Unfortunately, gluten resists digestion and the undigested fragments of gluten can have a morphine type effect that tricks the brain into thinking it is getting the glutamine it needs. When the effect wears off, you grow hungry again. Choose foods that contain glutamine - eggs, fish, meats, cabbage, beets, beans, spinach and parsley to satisfy gluten cravings.
Balance those Bacteria. Probiotics can help. Most people with celiac disease have dysbiosis, or an imbalance of intestinal bacteria. Dysbiosis will stop you from digesting properly or metabolizing energy well. You can get a bacterial overgrowth (of the bad bacteria) that covers the intestine, again interfering with absorption, or an overgrowth of another pathogen, like candida albicans, – which will make you crave sugars. Probiotics add back the good bacteria you need to protect your intestinal lining and help you digest and absorb nutrients.
Improve Motility. Try flaxseed meal, 1 tbsp taken at night mixed in a glass of water. Flaxseed is high in omega-3 fatty acids and soluble fiber and will help with gut motility. I say take at night, because taking fiber with meals can interfere with digestion and absorption of nutrients. (Fiber can bind the nutrients and carries them out of the body.)
Correct Acidosis by Eating Citrus. Citrus fruits like grapefruit and lemon brings up your pH levels and stops the acidosis that leads to inflammation, dysbiosis and poor digestion and absorption of nutrients.
100% GF. Make sure your gluten free diet is 100% gluten-free. 1mg daily has been shown to cause intestinal damage in some people. Most people seem to tolerate up to 25mg - but that's an 8th of a tspn. So, if you're eating a cookie during the week or sipping a low carb beer, you are not gluten-free.
Exercise. Try limited exercise to begin. As you correct your nutrient deficiencies and your body grows stronger, increase the amount. Walking is a great way to start. Weight training is excellent for building muscle and cardiovascular health at the same time. Yoga and pilates are perfect for building strength and flexibility.
Eliminate Sources of Inflammation. Review your diet to determine whether other foods beside gluten are causing an inflammatory reaction. (In my case Soy, Cow Dairy and Cane Sugar.) Also review your environment for other things that may be overstimulating your immune system: mold, medications, over-exercise. Inflammation can be recognized by swelling in the face, around the eyes and chin, or in the hands. Remove these inflammation causers.
I am proof positive that healing yourself and meeting your nutritional needs will help you lose unhealthy weight and gain lean muscle mass.
My results: 25 lbs weight loss over a period of 3 months and then 5 pounds increase in muscle - maintained almost 6 years now.
Before: I was 185 lbs and was killing myself at the gym 5 to 6 days a week. I could barely bench press my weight and my bloated body looked more like a sausage than the chiseled look I was shooting for. This picture was taken on June 21, 2003, before I went gluten-free.
Now: I weigh 165 lbs at 5'9" - with a 42” chest and a 32” waist. I can bench press 250 and am in better shape at 35 than I was at 25. This picture was was taken March 31, 2009.
Note: This article was first written in April, 2009. In October, I was in a car accident where I suffered a sprained neck that stopped me from exercising. Even without steady exercise over the Thanksgiving and Christmas holidays, I only gained 3 pounds. Here is a picture of me - taken today January 22, 2010.
Update 2014: Here is a photo from a 50 kilometer trail race I ran in February 2014, just in case you wanted to see what I look like more than four years after writing this article. I have gained almost 10 pounds of muscle from weight lifting here at age 40.
I changed my life – you can too!
------------------------- "Author Information: John Libonati, Philadelphia, PA Publisher, Glutenfreeworks.com. Editor & Publisher, Recognizing Celiac Disease. John can be reached at firstname.lastname@example.org."