Can people with celiac disease be of normal weight? Photo: CC--Tony Alter

Celiac.com 05/18/2016 - Common clinical wisdom, and some data, indicate that patients with celiac disease are likely to be underweight. However, data from west suggest that anywhere from 8% to 40% of celiac patients can be overweight or obese.

What about normal weight? Can people with celiac disease also have normal body weight? A research team recently set out to determine if people with celiac disease can be normal weight. The research team included I Singh, A Agnihotri, A Sharma, AK Verma, P Das, B Thakur, V Sreenivas, SD Gupta, V Ahuja, and GK Makharia.

They are variously affiliated with the Department of Gastroenterology and Human Nutrition, the Department of Pathology, the Department of Biostatistics, and the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.

To answer that question, a team of researchers recently reviewed data on body mass index (BMI) of patients with celiac disease so they could correlate BMI with other celiac characteristics. For their retrospective study, the team reviewed case records of 210 adolescent and adult celiac patients who were seen at the team's Celiac Disease Clinic.

To classify BMI as underweight, normal weight, overweight, or obese, they used the Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians for those with age >18 years and revised Indian Association of Pediatrics BMI-for-age charts for those between 12 and 18 years.

Their results showed that, of 210 patients, 115 patients were normal weight, while 76 patients were underweight, 13 were overweight, and 6 were obese. There was no difference in the proportion of underweight between male and female patients with celiac disease.

The mean age of underweight patients was similar to those who were normal or overweight. Regardless of weight, there was no difference between any of the patients in terms of average duration of symptoms; frequencies of diarrhea, anorexia, and weakness; anemia; titer of anti-tissue transglutaminase antibody; and severity of villous atrophy in those with underweight or normal weight or overweight.

Of the celiac disease patients in this clinic, only one third of patients with celiac disease actually had low BMI. More than half had normal BMI, while the rest were either overweight or obese.

Physicians should not discount the possibility of celiac disease based solely on BMI. Patients with normal and high BMI can also have celiac disease.

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