No popular authors found.

Categories

No categories found.


Join Celiac.com's forum / message board and get your questions answered! Our forum has nearly 1 MILLION POSTS, and over 62,000 MEMBERS just waiting to help you with any questions about celiac disease and the gluten-free diet. We'll see you there!






Follow / Share


  FOLLOW US:
Twitter Facebook Google Plus RSS Podcast Email  Get Email Alerts

SHARE:

Popular Articles

No popular articles found.
Celiac.com Sponsors:

No Evidence That Gluten-Free Diet Promotes Weight Loss (with Reply by Dr. Ron Hoggan)

Celiac.com 12/02/2011 - Some rumors have been circulating in the health foods community that gluten-free eating can encourage weight loss. Unfortunately, this theory is completely unfounded. Wendy Marcason, a registered dietician, published an article in the Journal of the American Dietetic Association in November that reviews some of the theories and controversy surrounding this issue. The article concludes that there is no scientific evidence to support a connection between eating gluten-free and losing weight.

Photo: CC--Newbirth35For those of us with celiac disease who start a gluten-free diet, weight gain is more often the case. The healing of the damaged intestines allows better absorption of food, and unless you rapidly change the amount of food you eat when you go gluten-free, most celiacs gain a substantial amount of weight after the switch. If you do not have celiac disease, however, eating gluten-free is unlikely to have any affect on weight independent from decreases in the overall calorie intake due to eating more carefully.

The consequence of this conclusion by the American Dietetic Association may be that more non-celiacs recognize that gluten-free does not necessarily mean more healthy. Unfortunately, some of the increased availability of gluten-free food over the last decade is owed to these non-celiac gluten-free folks. If these non-celiacs stop eating gluten-free, the demand for gluten-free food will fall and te number of options may decrease.

All of that said, the paper said that no evidence exists because there are no studies that look at weight loss on a gluten-free diet. While it's impossible to conclude that gluten-free diets cause weight loss, its also impossible to conclude that they don't cause weight-loss. Only a clinical study will be able to put the issue to rest.

Reference:

  • Marcason W. "Is There Evidence to Support the Claim that a Gluten-Free Diet Should Be Used for Weight Loss?" Journal of the American Dietetic Association. Nov 2011; 111(11): 1786.


Weight Loss and the Gluten Free Diet by Ron Hoggan, Ed. D.

First, I’d like to set Dr. O’Connell’s mind at rest. The claims for weight loss following adoption of a gluten-free diet aren’t merely rumors. They are credible claims based on peer reviewed and anecdotal reports, as well as published data from a qualified medical practitioner. For instance, Cheng and colleagues found that “54% of overweight and 47% of obese patients lost weight” (1). They investigated 81 subjects who were overweight and had celiac disease. Congruently, Venkatasubramani et al found that one half of their eight overweight pediatric patients also lost weight on a gluten free diet (2).

These reports alone cast an ominous shadow over Dr. Marcason’s claims if Dr. O’Connell has represented them correctly. Marcason, we are told, asserts that no research has been done on this question. Yet there are three such reports in the peer reviewed literature (1, 2, 3). One reports a preponderance of weight gain among overweight and obese celiac patients after beginning a gluten free diet, while the other two groups report that about half of the overweight and obese celiac patients, children and adults, lose weight on a gluten free diet. Not only has this research been conducted and most of the findings not only contradict the claim that no such research has been done, but two of the three reports indicate that the gluten free diet helps with weight loss in some individuals. I think it is important to notice that the study showing that a large majority of overweight/obese celiacs was conducted where wheat starch is accepted as appropriate for celiac patients, while the two studies that showed weight loss were conducted in the USA. We still don’t know enough about the interaction between various constituents of gluten and people who lose weight on a gluten free diet.  However, given the contradictions in findings, between research conducted in the USA and some parts of Europe, it is not unreasonable to suggest that these differences may result from wheat starch.  

Each of the three studies mentioned above have one large, consistent weakness. They are dealing with small numbers of patients. However, Dr. William Davis, a cardiologist has recently authored a book titled WHEAT BELLY, in which he reports that he has seen weight loss and other health improvements in more than 2,000 of his patients following adoption of a gluten free diet. And, of course, there are all the other anecdotal reports of similar benefits.

Dr. O’Connell’s opposition to the use of a gluten free diet ignores the dynamics of appetite enhancement and satiation that are largely driven by hormones resulting from variations in nutrient density in various parts of the body. From insulin to glucagon to leptin to ghrelin, these and several other fat mobilizing hormones enhance and suppress our hunger based on the nutrients in our bloodstreams, gastrointestinal tract, and adipose tissues.  

Dr. O’Connell also ascribes Marcason’s views to the American Dietetic Association which is the body that publishes the journal in which Dr. Marcason’s opinion article appears. While it may be true that the American Dietetics Association takes this position, it would be unusual for a journal, and the association that operates that journal, to underwrite the claims of one of its authors so I am skeptical that it has done so. I am especially skeptical of endorsement by the association, if Marcason has, indeed, stated that no studies have been conducted to investigate changes in body mass resulting from the gluten free diet among people who are overweight or obese at diagnosis. Clearly, this is an inaccurate claim whether it emanates from O’Connell or Marcason or even the American Dietetics Association.  

I am also left wondering if there are any studies that show that “gluten-free does not necessarily mean more healthy” [sic]. I haven’t seen any and I would be very surprised if any exist. Dr. O’Connell didn’t cite any such studies, yet she asserts that a gluten free diet is not a healthy choice for those who do not have celiac disease. This is especially troubling in view of the growing recognition of non-celiac gluten sensitivity as a legitimate disease entity (5, 6, 7, 8, 9, 10). 

I frequently write opinion articles so I would not want to inhibit such writing. Nonetheless, I believe that taking a rigid stance on either side of this issue is premature. Clearly we all have a lot to learn about weight loss and the gluten-free diet. The scanty evidence that is currently available is entirely too limited to say, with confidence, that the gluten-free diet is an effective weight loss tool, even for overweight patients with celiac disease. It appears to work for some, but other, unseen factors may be at work here.   

Sources:

  1. Cheng J, Brar PS, Lee AR, Green PH. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010 Apr;44(4):267-71.
  2. Venkatasubramani N, Telega G, Werlin SL. Obesity in pediatric celiac disease. J Pediatr Gastroenterol Nutr. 2010 Sep;51(3):295-7.
  3. Dickey W, Kearney N. Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. Am J Gastroenterol. 2006 Oct;101(10):2356-9.
  4. Davis W. Wheat Belly.Rodale, NY, NY 2011.
  5. Bizzaro N, Tozzoli R, Villalta D, Fabris M, Tonutti E. Cutting-Edge Issues in Celiac Disease and in Gluten Intolerance. Clin Rev Allergy Immunol. 2010 Dec 23.
  6. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
  7. Sbarbati A, Valletta E, Bertini M, Cipolli M, Morroni M, Pinelli L, Tatò L. Gluten sensitivity and 'normal' histology: is the intestinal mucosa really normal? Dig Liver Dis. 2003 Nov;35(11):768-73. PubMed PMID: 14674666.
  8. Di Cagno R, De Angelis M, De Pasquale I, Ndagijimana M, Vernocchi P, Ricciuti P, Gagliardi F, Laghi L, Crecchio C, Guerzoni ME, Gobbetti M, Francavilla R. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization. BMC Microbiol. 2011 Oct 4;11:219.
  9. Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR. Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol. 2011 Mar;106(3):508-14
  10. Bizzaro N, Tozzoli R, Villalta D, Fabris M, Tonutti E. Cutting-Edge Issues in Celiac Disease and in Gluten Intolerance. Clin Rev Allergy Immunol. 2010 Dec 23.



Amy O'Connell, MD, PhD's Reply to Dr. Ron Hoggan:

This is Dr. O'Connell replying. My piece was merely a summary of an article in the Journal of the ADA. The short summary I wrote was not intended to be an end-all conclusive statement about the matter. That said, the Cheng article that is cited by Ron Hoggard. M.Ed. was not designed to look at the outcome of weight loss in overweight celiacs and is underpowered to make the conclusions that he cites. Another quote from the same article said, "Overall, 54% [of patients who started a gluten-free diet] gained weight and 38% lost weight." The same problem with a lack of statistical power exists for the Venkatasubramani paper. Four obese patients lost weight on a gluten-free diet but 2 gained weight and 1 was lost to follow up. I'd like to apologize if my brief summary seemed too closed-ended, but I will stand by my article conclusion, "While it's impossible to conclude that gluten-free diets cause weight loss, its also impossible to conclude that they don't cause weight-loss. Only a clinical study will be able to put the issue to rest."


Celiac.com welcomes your comments below (registration is NOT required).



Related Articles




Spread The Word





11 Responses:

 
Nathan
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
02 Dec 2011 1:23:43 AM PST
I think that saying any type of diet based on one food source or type causes weight loss or doesn't cause weight loss is a little narrow minded... its like saying a diet with no carbohydrate causes weight loss... it may or it may not dependent on other foods and factors within the diet... why not just look to basic principles that eating unprocessed foods without chemicals, yes without irritants such as gluten, and with plenty of water WILL cause weight loss for the majority of people especially alongside regular activity or exercise... do we need to over-complicate it?

 
Lisa Thompson
Rating: ratingfullratingfullratingemptyratingemptyratingempty Unrated
said this on
02 Dec 2011 10:03:12 AM PST
I believe Dr. O'Connell was treated fairly. If you are going to make such bold statements in a public arena, you should be prepared for any responses that might contradict you, ready to back them up with the appropriate data.

Perhaps most of those with true celiac disease indeed gain weight after going gluten-free. But those with gluten-sensitivity, like my husband, myself, and a dear friend of mine, all lost a tremendous amount of weight after going gluten-free, not to mention a disappearance of lifetime gastrointestinal illness, arthritis-like pain and skin conditions. The wheat industry and it's lobbyists can try to persuade the Purveyors of Higher Learning to discredit the notion all they want, but it's becoming undeniable by the overwhelming anecdotal evidence that something is terribly wrong with today's wheat. When everyone in the city is sick and gets well after they stop drinking the water, is anyone going to believe the Town Crier who insists the well is pure?

 
Coloradosue
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
06 Dec 2011 4:37:44 PM PST
With the revolution of genetics in the food industry, it was just a matter of time before someone finally said out loud, "What are we doing to the human body by using this radically changed wheat grain in our food?" Well, more people are getting sick! After the initial trigger of double pneumonia, my celiac disease was "turned on" causing a one week weight loss of 11 pounds. Since going “gluten free” in 2004, (which really is impossible to do when so many products may use one of the 3 confirmed glutens wheat, barley & rye, that are coming from countries that neglect to inform and/or print ALL of the ingredients in their products despite regulations to the contrary. I had gained 38 lbs going gluten free. Then I was diagnosed with Fibromyalgia (to go along with the Spinal Stenosis that I was diagnosed in 2003), the following year so exercising to lose weight became a mote point. Watching my "diet" is an exercise in futility . I can usually expect to be "sick" at least once a month despite due diligence to my diet. And yes I do lose weight during these attacks but my system takes a tremendous hit. And then I gain it back. I greatly fear that may develop "Lymphoma" as my younger sister did and died in 1990 at age 34. My family now believes she had un-diagnosed celiac disease.
So to those of you trying to lose weight by going on a gluten free diet, good for you. Should you develop celiac disease or sensitivity down the road, at least you had a head start. Good Luck!

 
Heather Twist
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
02 Dec 2011 9:33:03 PM PST
Kudos to Dr. Hoggan!

As anecdotal evidence, I can offer the following. Our whole family went gluten-free. I am celiac, the others are not. THEY lost weight, and are no longer chubby. And I gained weight! It appears that my years of overeating and being skinny have ended, now that I actually digest food.

I don't think there is a simple answer like "gluten makes you gain weight". I do think it is something like "gluten messes with your appetite and weight". For some it makes you overly skinny, for others, overly fat, for some, neither.

 
Suzanne
Rating: ratingfullratingfullratingemptyratingemptyratingempty Unrated
said this on
05 Dec 2011 6:53:50 AM PST
As one who nearly died before being diagnosed with celiac disease, it's frustrating to see articles that would lead anyone to question the validity of going GF, if necessary, and properly done. Patients who are as ill as I was lose weight prior to diagnosis - I am 5'6" and was down to 89lbs. Weight gain was a desired result of the GFD. Unless the context is taken into account all the stats are useless. The diet itself should be controlled in any study since one can eat as poorly on the GFD as on a wheat based diet. Thank you, Dr. Hogan, for coming to the defense of those of us who need all the support we can get.
Thank you, Nathan and Lisa for your replies, as well.

 
Janet
Rating: ratingfullratingemptyratingemptyratingemptyratingempty Unrated
said this on
05 Dec 2011 8:44:28 AM PST
For me, a gluten-intolerant celiac with wheat allergy, I lost weight, sizes in fact. Why? Because I had to think twice about what I was putting in my mouth for starters. When I was hungry and in a rush, I would not eat the snacks on the shelf. No Oreos. No Hostess cupcakes. Sandwiches became bread-less. No pizza. And the majority of restaurants use flour for sauces and whatnot so it was chicken breasts and veggies. So, YES. When you go GF you WILL lose weight unless you replace every item with a GF equivalent. Most tastes bad, IMO, so you will be eating less of it and therefore less carbs. It did not all drop off immediately, and took a couple months for me. And I agree with Lisa, as many symptoms I had disappeared.

 
frazer edwards
Rating: ratingfullratingemptyratingemptyratingemptyratingempty Unrated
said this on
05 Dec 2011 3:20:49 PM PST
I think it highly likely that those that follow a grain free, legume free, dairy free and industrial oil free diet will lose weight. The "baked" goods espoused on this site do color the conversation as does almost any reliance on the opinions of nutritionists.

 
Sharon
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
06 Dec 2011 8:20:27 AM PST
Here is my educated hypothesis with some anecdotal evidence regarding weight gain/weight loss with celiac or other gluten issues. Normal weight or underweight celiac patients who are diagnosed often gain weight simply from continuing to eat in the huge amounts of food that were never absorbed. They need to adjust their eating now that nutrients are being absorbed, else they will gain weight. Simple enough and well documented.

Many overweight people complain they do not overeat and are exercising but struggle to lose weight – often giving up the fight and easily gaining it back. While doctors have raised the potential link between obesity and celiac disease (or at least that obese people may also have the disease not just thin folks), no one has explained the obesity-celiac process/link well. One month working with my longtime dietician, I lost a few lbs. She trusted me and believed what I was eating and my 20-25 miles a week of mixed-paced walking and other exercise documented on paper. A doctor on another celiac website explained it similarly to Dr. Hoggan – that overweight folks with celiac have bodies that are starving for energy at the cellar level that places them into a low metabolic mode telling their brains, hormones, etc. to eat, eat, eat (feed me!). Dr. Green in his book disappointingly does not handle obesity with celiac disease explanation in this manner and notes obese celiac disease folks have enough of good small intestinal villi with atrophied - flattened that they can absorb nutrients that then make them fat. I prefer to lean towards the former theory or perhaps a combination of both.

I have a personal story that reads like Ms. Celiac – and explains much of my family’s issues as well. I refused testing for celiac last year after complaining to my doctor about widespread joint pain when eating anything with added gluten - figuring I would just stay away from it. I was ignorant at the time of all the ramifications of celiac disease. Still, I am a bad patient who went gluten free before being tested after an uptick in symptoms – including GI ones. The result? I have never felt better in my live, and the nutritional and exercise program that lead to just 20 lbs off in 2 years is now more effective, and the weight is coming off (the discovery of a gluten free bakery’s goodies put me temporarily off track!). On a program of good healthy protein, gluten free, low fat, and sugar free foods, I am no longer hungry all the time (even forgetting to eat at times until I look at the clock). I eat slower and am full faster. Spirits up, energy up, clearer thinking, no joint pains, bowels normal - thought all my life I was normal in this regard but apparently not, other odd issues improved as well.

I do believe celiac or related gluten issues may indeed as Dr. Green notes be a hidden epidemic and that more obese folks with inflammatory-based diseases need to be tested as they may finally be able to do what they were doing all along to lose weight but the gluten was metabolically prohibiting success.

 
Shar
Rating: ratingfullratingfullratingfullratingfullratingempty Unrated
said this on
06 Dec 2011 8:45:56 AM PST
I lost weight after celiac diagnosis. I felt it was primarily due to feeling so much better and having the energy to engage in physical work again.

I also think that having to be careful about snacking and passing up most of the samples at Costco cuts down on calories.

If everybody asks Costco in their suggestion box to have gluten free bread maybe they would start carrying it.

 
christine
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
07 Dec 2011 8:02:43 AM PST
I too am losing weight after going gluten free. Because of the positive changes that I have seen in my body (I'm 41 and finally have soft, shiny hair, joint pain is gone, muscle weakness gone, no more bleeding gums, no more pasty complexion, no fogginess, especially after eating, more energy than I have ever had in my life, no more congestion, no more curled up hands and feet, no more cravings, and constantly feeling hungry, the list goes on...) I believe that my constant hunger was due to malnutrition from gluten, and not from my thyroid disorder as I had previously thought. I don't feel hungry all the time anymore! It's been nearly a month since going gluten free and I feel like I have my life back. Honestly, the pain and other symptoms were so bad before I wondered what the point was to living a life like this. Now, I'm losing about 1 pound every three days, and I'm eating great! I'm just not constantly eating the junk I was craving before. So, indirectly by causing malnourishment, gluten certainly does contribute to weight issues.

 
Ginger
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
08 Dec 2011 11:13:57 AM PST
I was underweight my whole life, eating gluten free is helping me from fading away. My metabolism is way too fast. I can't gain weight on a gluten or gluten free diet. There may be other issues but thank you Dr. Hoggan for reiterating the facts for us. Everyone is different, it does depend on their genetic history, pathologies that they are facing and the current type of food that they are incorporating in their diet that is "gluten free".
The rating is for Dr. Hoggan




Rate this article and leave a comment:
Rating: * Poor Excellent
Your Name *: Email (private) *: