People with celiac disease traditionally have been thought to be underweight because of nutrient malabsorption. But celiacs are overweight much more often than underweight and the vast majority who go on a gluten-free diet gain additional weight, according to a study in the October 2006 American Journal of Gastroenterology.
Celiac disease is an autoimmune disorder in the gut caused by an intolerance to gluten, a protein found in wheat, rye, barley and other grains. The study reviewed data on 371 patients diagnosed with celiac disease over a 10-year period in a clinic in northern Ireland. Only 4 percent of the patients were underweight when diagnosed while 39 percent were overweight and 57 percent were normal weight. After strictly eliminating gluten from the diet for two years, 81 percent of the patients gained weight, including 82 percent of the initially overweight patients. The proportion of patients in the overweight category jumped from 26 percent to 51 percent.
To avoid missing or delaying diagnosis of celiac disease, physicians need to be aware that many celiacs are overweight and less likely to have the so-called classic symptoms: diarrhea, severe gut damage, reduced hemoglobin levels and low bone mineral densities.
The typical gluten-free diet as conventionally prescribed needs to be modified to prevent weight gain. The authors of the study did not say how, but a safe bet is to avoid gluten-free refined flours, high-sugar foods and partially hydrogenated oils. Instead, emphasize low-calorie, non-starchy vegetables and lean proteins. It’s also important to watch your intake of gluten-free “goodies,” such as cookies, cakes and muffins. While these treats may be fine on occasion, regular consumption can show up on the scale.
Melissa Diane Smith is the author of Going Against the Grain. Details on how to design a weight-reducing/weight-control, gluten-free diet are covered in the book as well as through personal phone consultations with Melissa.