Celiac.com 03/08/2010 - Celiac, a genetic autoimmune disease, has long been associated with a medical picture of patients that look underweight, and malnourished. However, recent studies are finding that obesity and a high BMI (Body Mass Index) may also be prominent in celiac patients. New studies were conducted to determine BMI changes after initiation of a gluten-free diet, and they offer clues to the importance of eating gluten free after being diagnosed with celiac disease.

Doctors at the Celiac Disease Center of Columbia University studied the BMI of 369 patients proven through biopsy to have celiac disease, spanning from 1981 to 2007. Men and women were evaluated separately for the sake of this study and the test patients were classified as “classical” meaning diarrhea prominent, or “atypical” meaning they had no diarrhea at the time of celiac diagnosis. Atypical patients were further divided into groups of 'anemia present' and 'no anemia present' at time of diagnosis. Body Mass Index was then categorized into four groups based on the criteria of the World Health Organization.

The BMI of all test celiac patients were compared to the general United States population. Using the regression model, the study found that there are obvious predictors for low BMI; patients classified as “classical” celiac, female, and with severe villous atrophy, were all revealed as predictors for low BMI. These findings further exemplify that the most dramatic changes in BMI rates were in underweight females with celiac disease. Celiac females had a considerably lower mean BMI than the general population, thereby indicating an important association between females with celiac disease and low BMI. In fact, celiac females that tested with a normal or low BMI were also found to have higher rates of critical villous atrophy than those with a higher BMI. However, more males with celiac were found to be overweight compared to the general population.

After initiating a gluten free diet, most BMI changes were shown to be directly associated with an initial baseline appearance of “classical” symptoms. While on a gluten free diet, over 50% of the overweight and obese patients lost weight, and of the group who initially had a low BMI, 42.4% attained a normal weight. Thereby concluding that treatment of a gluten free diet after celiac diagnosis provides advantageous changes in BMI results. Further evidence of the importance in early diagnosis and prompt treatment of celiac disease.

Of course it is critical to note that, all the patients utilized for this study were monitored closely by a care center dedicated to celiac disease, and continually followed by an experienced dietician with expert knowledge of celiac disease. And, while you may not be able to afford the kind of dietician these patients were provided with, it is always very important to be under the care of a doctor or clinic dedicated to treating celiac disease, as well as to be receiving experienced dietary counseling when transitioning to a gluten free diet.

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