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  • Scott Adams
    Scott Adams

    Celiac Disease and Obesity—There is a Connection by Melissa Croda q

    Reviewed and edited by a celiac disease expert.

    This article appeared in the Winter 2006 edition of Celiac.coms Scott-Free Newsletter.

    Celiac.com 07/10/2006 - Three years ago my father was diagnosed with celiac disease and I was told by my mother that it is hereditary and that I too should get screened for it. I did some research and immediately knew that I had this disease. I wouldn't admit it to anyone at the time because how on earth could I possibly live without pasta and fresh-baked bread for the rest of my life?! You should know that I have been sick for my entire life—I had colic until I was six, got ulcers when I was eight, appendicitis at 14, calcium bone spurs at 17, 19, 24 and 36, infertility at 24, gall stones at 37—just to mention a few of the conditions Ive had that were likely related to my untreated celiac disease.

    About six months later I decided to go see my doctor—I was in a severe state of depression, and I had lost the ability to think—much less talk. Carrying on a full conversation was nearly impossible because of my inability to speak in full sentences. I was extremely sick with a severe cold, and I had an infection or the flu at least once each month for the preceding two to three years. I told my doctor that I thought that he should test me for celiac disease. Since I weighed in at over 300 pounds he literally laughed at this idea. According to him there was absolutely no way that I could have celiac disease—because I was fat!

    Shortly after that my parents came to visit and tried to talk me into eating gluten-free—at least during the time that they were here. I agreed because I had to cook gluten-free for them anyway. Within three days of starting a gluten-free diet I felt like a million bucks. My depression lifted and within a month I was losing weight and my brain started working again. I have been gluten-free for three years now—not only do I feel like a million bucks, but I have lost over 100 pounds. I shudder at the idea that I was literally eating myself to death—and it was not because I didn't have any will power or that I was eating bad food—it was because my body couldnt process and absorb the food that I was eating. My personal experience, combined with my research, has left me completely convinced that celiac disease is (and will continue to be) a significant cause of obesity—and that this will continue to be the case until there is a better understanding of the disease and its relationship to obesity.

    What is Celiac Disease?
    Celiac disease is a permanent intolerance to gluten1, which is a protein found in, wheat, rye, and barley. When gluten is ingested the digestive system is unable to properly break it down, and an autoimmune response is triggered in the gut that causes the villi of the small intestine to become damaged—leading to malabsorption of crucial nutrients. There is no cure, and the only way to control it is through a 100% gluten-free diet.

    The disease has a vast array of symptoms, and it is rare that two people will exhibit the same ones. Some will have diarrhea while others will have constipation, and some will not have either but instead may have osteoporosis, diabetes, headaches, fatigue, autoimmune thyroid disorder or any number of other conditions and symptoms found to be associated with it. In many cases these symptoms are associated with the inability to gain weight—children with celiac disease are often small and fail to thrive 1.

    Nearly every source that I consulted for this paper referred to malabsorption and how most people with celiac disease lost weight or couldn't gain weight. Only a few sources even mentioned obesity—and when they did it was only in passing. As celiac disease awareness steadily increases and more research is done on it hopefully it will become apparent that many cases of obesity are also related to it.

    The Common Thread
    Autoimmune thyroid disease has recently been linked to celiac disease. Recent research has demonstrated that 3.4% of patients with autoimmune thyroid disease also have celiac disease2. The thyroid gland secretes hormones to control the body's metabolic rate3, and to accomplish this it must have iodine. When celiac disease is present along with autoimmune thyroid disorder, the body does not have the ability to absorb the iodine to produce the necessary hormones. Additionally there are many different disorders such as obesity, diabetes, allergies, weight-loss, gastrointestinal problems, etc., that can be caused by having a damaged or compromised thyroid gland3 (all of these disorders, by the way, can be related to celiac disease). It has been known for years that obesity has been linked to thyroid problems, and that the thyroid produces 5-monodeiodinase, the bodys natural method of conserving fuel during shortage," and the body "elicits the same physical reaction as famine," which can then cause the affected person to gain weight3.

    Another disorder commonly associated with celiac disease is malabsorption, which can also lead to malnutrition. When someone with celiac disease eats foods that contain gluten it results in damage to the surface of the small intestine and destruction of their nutrient-absorbing villi. This can lead to leaky gut and an inability for them to absorb vital nutrients from their food. By continuing to eat foods containing gluten, eventually vital organs including the brain, thyroid, liver, kidneys—essentially any organ that depends heavily on nutrients—will be starved, which will leave them susceptible to other diseases and conditions. I personally experienced brain malfunctions, gall bladder problems, and was diagnosed numerous times with an under-active thyroid. Naturally treatments for this proposed thyroid condition didnt work because their true cause had not yet been found. At one point a doctor asked me to consider the idea that my obesity was the result of my bodys attempt to cope with malnourishment4. This phenomenon is similar to yo-yo dieting, where dieters who have deprived themselves or proper nutrition for too long gain weight at faster rates than non-dieters after they resume eating normally. I always thought that I had fallen victim to yo-yo dieting, and that I had dieted myself into a permanent state of obesity. I now understand that it was because I had undiagnosed celiac disease, and my body was actually malnourished.

    Under normal nutritional conditions humans only absorb about 80 percent of the nutrients from the food they eat, and the rest of the nutrients pass through the body4. With celiac disease, however, the body is unable to absorb the necessary nutrients, which causes some peoples bodies to become a super-efficient machine that begins storing as much fat as possible in order to survive. This nutrient deficiency convinces the body that it is starving to death, which sends it into starvation-mode. Since humans need a certain percentage of body fat reserves to stay alive—and because it takes more work for the body to burn fats than carbohydrates—a body that is in starvation mode tends to crave carbohydrates and more efficiently convert them to fat for later use4.

    There has been much research that links celiac disease to diabetes. Diabetes occurs when the bodys cells are unable to absorb enough blood sugar5. Although the cause is different, the resulting malabsorption is similar to that seem in celiac disease—although in the latter the malabsorption is not just limited to sugar. The connection between diabetes and celiac disease as described by Marschilok:

    Both diseases have genetic and environmental origins. This means an individual is more at risk of developing either problem when a close relative also has it. On the genetic side, development of one reveals the pre-existing and larger risk that the genes for the other may be present. At least two genes and gene locations are connected with each disease. One gene for each disease is near one gene for the other on the same chromosome. Nearby genes are more likely to pass together to offspring.

    However, while the genes are necessary, they are not sufficient to produce the diseases. On the environmental side, researchers know gluten is needed to produce celiac disease, but they also know its not the only environmental cause. With diabetes, the environmental causes are being extensively studied for prevention and cure. Roughly ten percent of celiacs either have Type I diabetes or might develop Type II diabetes6 .

    An astonishing 40% of people with diabetes are also obese—even though there was not very much in the way of medical research to indicate why this is so. Diabetes is described as your cells inability to produce or absorb insulin, which leads to an excess of sugar in the blood stream7. If a person injects or produces too much insulin it will increase the level of hunger and cause obesity. I personally find this information disturbing as there are some in the medical community who still blame obesity on character flaws—I cant begin to tell you how many times I have been told: if you just didn't eat so much you wouldn't be fat.

    A number of overweight and obese acquaintances of mine have asked me how I managed to lose over 100 pounds and look so healthy while doing it. I explained my celiac disease diagnosis and gluten-free diet to them, and how the diet has made me not feel hungry for the first time in my life—due to the fact that I am now absorbing nutrients properly. Six of these extremely obese people have actually gone to their physicians to get tested for celiac disease—and each was met with the same skepticism as me. They persisted and finally got their doctors to perform the necessary tests—and to the surprise of all each were diagnosed with celiac disease! Immediately after going on the gluten-free diet they all experienced a decrease in hunger and massive weight-loss. For the first time they were eating only when their bodies were truly hungry, instead of eating too much due to starvation signals caused by malabsorption.

    This could also be part of the reason that high protein, low carbohydrate diets work so well for many people. By removing the carbohydrates from ones diet you generally remove a large portion of the gluten as well, which can cause those with celiac disease who are obese to lose weight quickly—at least for a month or so. However, on the high protein diet you are still not removing all gluten which will eventually cause them to gain the weight back—even though they are still on the diet. This was my experience with the low carbohydrate diet, and I suspect that a lot of others who are obese and have undiagnosed celiac disease had or will have the same experience.

    Conclusion
    I once had a family member literally yell at me about my weight and ask me why I was being so selfish and not thinking about my husband and daughter—they told me that I should just lose the weight. I was devastated, I truly had tried every diet on the face of the earth and each and every time I would loose 20-30 pounds quickly (regardless of the type of diet), only to gain it back (while still following the program)—sometimes as much as two fold! Since being diagnosed with celiac disease three years ago I have not only lost the weight but I have also kept it off, and each week a little bit more comes off. I am completely convinced that celiac disease does and will continue to be a common cause of obesity until the medical community—through scientific research—realizes that there is a connection.

    Many obese people might not be overweight if they were just properly diagnosed and treated. Certainly it is not the case that all obese people are that way because they just plain eat too much and do not have any will power. I suspect that there are better medical reasons to explain most cases of obesity, and celiac disease is just one of them. Not too long ago it was estimated that celiac disease only affected 1 in 10,000 Americans8. That figure was then revised to 1 in 5,000, and now, after much research, it is at least 1 in 133. The actual diagnosis rate, however, is only about 1 in 5,000, which is only a small fraction of those who have it. Similarly, the causes of obesity in America are not fully understood, and more research needs to be done to determine just how many cases of obesity are caused by untreated celiac disease. I believe that a significant percentage of obese people have undiagnosed celiac disease, and that celiac disease screening should be part of ordinary blood workups for all obese people.

    References:

    • Adams, S. (May 2005). A Celiac Disease and Gluten-Free Resource since 1995. Retrieved May 18, 2005, from www.celiac.com.
    • Collin, Kaukinen, Valimaki & Salmi, (2002). Endocinological Disorders and Celiac Disease, Endocrine Reviews (pp 1-38).
      3. Life Extension, Thyroid Deficiency, Online reference for Health Concerns. Retrieved May 26, 2005 from www.lef.org/protocols/prtcls-txt/t-prtcl-104.html.
    • Balley, L. (June 2004) Obesity in Developing Countries Compares to U.S. Yo-Yo Dieting. Retrieved June 16, 2005 from: http://www.eurekalert.org/pub_releases/2004-06/uom-oid060804.php.
    • Katz H., (2005). Hope for Obesity and Diabetes. Retrieved June 19, 2005 from http://www.reporter-archive.mcgill.ca/Rep/r3112/mice.html.
    • Marschilok, K., (1997). Diabetes and celiac Disease. Gluten-free Living.
    • Hoover, J., (2001). Obesity Causes Diabetes–Fat Chance! Diabetes Health Magazine. Retrieved June 19, 2005 from http://www.diabeteshealth.com/read,1009,2168.html
    • Vogren, C.L., (September 15, 2003). Awareness Can Be Best Medicine: Parents who lost son to celiac disease want to shed light on often-overlooked ailment. The Gazette. Retrieved June 19, 2005 from http://www.csaceliacs.org/CDintheNews/COSpringsGazette091503.php

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    I am extremely thrilled to have found this article. It answers many, many questions for me. FINALLY!!! After 10 years of chronic illness that no M.D. was able to diagnose--aside from chalking it all up to CFIDS. Believe me, I have been to every medical specialist in the book. Thank you so much!

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    Very interesting article. My mother was diagnosed 22 years ago with Dermatitis Herpetiformis and was told it was related to celiac disease. She followed her "special diet" for 2 years religiously and did very well. However when her specialist moved away, her eating slipped and she has not eaten gluten free for at least 18 years. Needless to say she is hypothyroid, type II diabetic, has rheumatoid arthritis and low ferritin levels. I keep telling her that all she has to do to feel better is to get back on her gluten free diet.

     

    Interestingly enough, when I was in college I started to have similar skin symptoms as my mother did before her diagnosis, but nothing was done. Then as I entered my clinical year in college (I am a laboratory technologist/scientist) and was dealing with bouts of diarrhea...so off to the Gastro doc and after a colonoscopy was told I had ulcerative colitis, however, after moving to another city and getting a new Gastro doc, and yet another scope the diagnosis was now "just" IBS. Was told to manage with Imodium and watch my stress! Gall bladder attack after my second baby, which came out. Tired all the time. Numerous blood test for celiac disease at my request all came back negative, but even looking at the reports there was a disclaimer for false negatives. So I started to see a Naturopath last October, and after going through my health history, the first thing she told me to do is to go gluten free. I feel much better, although still dealing with a few issues, but was told it could take up to a year for my body to fully heal. I have had only one bout of "the runs" since then. I have slipped up a couple of times and can really tell the difference, not to mention the increased trips to the bathroom!

     

    I hope that more doctors start to realize that just because you don't fit the picture of a certain disease, doesn't mean that you can't have it. Thanks for the article, it was a great read.

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    Exactly the same thing has happened to me. I reached my goal with Weight Watchers (which took ages). Then I was diagnosed with celiac disease just under a year ago and I have gained 1 stone and 7 lbs. How depressing! Have you received any useful information or advice?

    I totally understand, I was diagnosed with coeliac about 5 years ago and I rapidly gained weight (now 30 kgs above ideal) and have had trouble loosing it despite trying many different diets. Fairly sure there is no hidden gluten in my diet but have always struggled with weight loss until I spent 2 years really sick before my diagnosis. All the clear liquids and dry toast suggested as a remedy for diarrhea must have built up to eventually result in a positive blood test followed by biopsy. I would really like to know if anyone has any good advice on weight loss ideas too.

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    Thank you very much for this website. I had issues with extreme weight gain and endocrine problems. I gained 50 lbs in one year. My doctors all complain that I overeat, etc. Which wasn't always true. Yes, there were times where I was STARVING and could easily take out a CIA agent if he was guarding an all you-can-eat buffet. But really, I didn't eat any more or any different than I did in the past.

     

    So when they gave me medicine to treat the endocrine part, I did lose weight and fast. But only 10 lbs in 2 months. But the medicine helped to keep my weight stable instead of gaining 2-4 lbs per month. Then the same doctor (which was all of them really) who continuously chastised me about my weight decided to do a celiac test on me. I thought she was crazy. Well the test came back negative for celiac, but extremely positive for one of the antibodies. I remembered feeling better after experimenting for 1 week on a diet that wouldn't let me have bread, dairy, sugar or salt. My joints didn't hurt etc.

     

    So when I stay away from dairy and gluten I feel better. I don't have that fuzzy head feeling. I don't have as much body pain, I don't have a weird body odor. Combining this with probiotics I saw a huge weight difference in one week as my stomach went flat!

     

    I am not sure what is the cause for my issue with gluten other than what the celiac test indicate. But whenever someone has hormone issues or even spinal alignment issues that can affect digestion also. My endocrine issue is neuroendocrine so right after having the neuroendocrine/auto immune issue is when I had a huge issue with digestion that I never had before and it was like it appeared overnight!

     

    Knowing about celiac or being gluten insensitive is now helping me get through life a little better. But hopefully more doctors will see your website and realize obesity isn't because of "control" its because of other factors like endocrine, dopamine, malabsorption, etc.

     

    My intense need for food was due to my body saying "We have no nutrients here!!!" and if I ever have episodes where I'm just famished I know that I'm either dopamine deficient due to not taking medicine or not eating for a long time that day or that I'm eating stuff that is blocking my absorption of minerals. Precursor to Dopamine is Tyrosine and Vitamin D. If you're not absorbing any of these in your food, you're in trouble and can lead to issues with endocrine functioning as Vitamin D is linked to Hypothalamus and Pituitary functioning that affects things like thyroid, estrogen, etc.

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    I too am heavy with celiac disease. Not officially diagnosed yet, but I know that is what it is. I have weighed the exact same for ten years after I gained 100 pounds in less than two years. I am just like you - sick my entire life. Biggest sicky years age: infant, 5, 8, 10, 12, 14, 15, 19, 21, 24, 25. I am now in the depression/anxiety, can't think straight stage, with numbness in my arms and legs, hair falling out, and itchy skin. I want to be tested and officially diagnosed before I quit eating gluten, but it gets harder every day. And quitting isn't easy either.

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    I too am heavy with celiac disease. Not officially diagnosed yet, but I know that is what it is. I have weighed the exact same for ten years after I gained 100 pounds in less than two years. I am just like you - sick my entire life. Biggest sicky years age: infant, 5, 8, 10, 12, 14, 15, 19, 21, 24, 25. I am now in the depression/anxiety, can't think straight stage, with numbness in my arms and legs, hair falling out, and itchy skin. I want to be tested and officially diagnosed before I quit eating gluten, but it gets harder every day. And quitting isn't easy either.

    I hope you don't wait to be officially tested before you stop eating gluten. Stop eating it and you will feel better quickly. I suffered from severe anxiety at one point and I cannot think of anything worse. I have also had constipation, bloating, skin rashes, hives, pneumonia many time while growing up, anemia for years, bone spurs, continuous join pain since I was in my mid 30's, etc.

     

    If you eat protein like turkey, chicken, beef, salmon, other fish it stays with you longer than carbs and you don't have to worry about being hungry. I have lost weight and so has my son who went gluten free in September. He no longer has severe rashes and other symptoms. My stomach feels better, no bloating usually, way less headaches and happier. Make sure you take supplements; vitamin d and omega 3's for depression are important. The B vitamins too. Be sure to take vitamin C which helps your B vitamins be absorbed. It's hard to change what you eat if you stay hungry, but if you start eating more protein along with vegetables, fruit, and rice you feel satisfied and get better. It's really helpful to carry some almonds with you wherever you go to pop in your mouth when feeling hungry and not at home. They are healthy and get rid of the hungry feeling.

     

    I hope you help yourself feel better and take action. Your health depends on it.

    P.S. I love pizza and goat cheese! Amy's frozen pizza is the best. I especially lover her Dairy Free and Gluten Free Pizza with roasted vegetables. I simply add freshly grated Romano or Goat Cheese on the top. The crust is great, when cooked in the oven. There are some other great products available that are delicious and will help you make the change.

     

    All the best,

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    Excellent information....I'm astounded how little doctors know, even specialists, in this regard. How many are truly suffering from gluten sensitivity or celiac disease and are only having symptoms treated? I was diagnosed w/Hashimotos hypothyroidism several months ago, I had my gall bladder removed in 1995 due to gallstone/attack, I had ulcerative colitis as far back as 1988. I've had upper respiratory problems, having walking pneumonia 3 times in my life....I could go on. I started to research on my own and educated myself. I found the possible gluten connection to all these things that I have or had suffered with. I went to my gastro/doc and asked to have blood test for celiacs. It just came back negative. Now I see that they can be wrong. Why have a blood test then?!!! Is the saliva test more accurate? I'm so tired of doctors appointments and am thinking to just go gluten-free and see if my symptoms get better. It makes me put little faith in doctors as they are only seemingly treating symptoms and not addressing the cause to many diseases or conditions. I do appreciate the info. I found here, it is like a breath of fresh air....thank you.

    Go gluten free and you have a great chance to change your life for the better. Unfortunately it cost tons of money going to various doctors without ever having a definitive answer from any of them. That is usually the case, however, not always. When my cholesterol improved my doctor said "whatever you are doing, keep it up". He didn't even care to ask what I was doing. At the time I was not gluten free, but I did start taking supplements, and especially Alpha Lipoic Acid, which helps regulate your blood sugar. Wouldn't it have been great if my doctor would have recommended helpful supplements instead of saying that high cholesterol is just hereditary most of the time. I have had bloating, constipation (thus a colonoscopy), heart burn, joint pain and bone spurs in my adult yrs.; pneumonia in 3rd, 5th, 7th, 11th grade, in college, and age 40. We rarely ever ate simple carbs when I was growing up except for sandwich bread; no bread at dinner, infrequent desserts, etc. so when I when to college and started eating lots and lots of carbs. I gained weight, got heart burn, started having stomach problems, rashes, and depression/anxiety which were additional health problems to the childhood upper respiratory ailments. This is the first time since starting college that I don't feel like I am fighting depression everyday.

     

    I really hope that a gluten free diet will help you get to your optimum health!

     

    All the best!

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    Guest jenni webster

    Posted

    My sister is coeliac and my mum died of non Hodgkins Lymphoma T cell, which is a main cause of death for non diagnosed coeliacs. I have tested negative in blood tests for coeliac but am not absorbing B12. I am well over-weight and always craving wheat unless I stay off wheat altogether and then the hunger goes, the joint stiffness and heartburn goes and the weight drops. I should having an endoscopy soon, I hope.

    Don't forget if you're taking the blood tests for celiac, you must eat a lot of gluten containing foods in order for the test to work right. But a biopsy is the best way

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    Thank you for writing this. I wanted to cry when I read this article. I've struggled with stomach pain, diarrhea, type 1 diabetes, hypothyroid, depression, anxiety and obesity almost my entire life. I'm now 31 years old and finally getting tested because I ASKED to be tested. I feel validated after reading your article.

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    Thank you so much I have been diagnosed this year

    and I was gaining weight about 5 lbs. a month for 6 months before.

     

    I am not loosing as much as I would like though and I have no bread at all or pasta. I use very little of the celiac food

    because they are so high in calories . I have been eating

    Weight Watchers soup and some chicken each day for 2 weeks and I have egg whites for breakfast

    and fruit.

    Make sure you read the label, many soups have gluten.

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    This article definitely brings a lot of important things to light. For the past year or so I've been having less energy every day and could feel my hunger gradually increasing. Recently it got to the point where I'd have insane amounts of food just to keep myself from feeling like I was starving. It was only until I stumbled onto this disease and eliminated gluten from my diet that I started to feel energized again.

     

    While I don't think I'm a full blown celiac, I did experience symptoms in my childhood that could point to gluten intolerance. These symptoms included lactose intolerance at infancy (milk eventually became tolerable), reduced growth in height as well as easy bruising.

     

    This might show that you don't have to be a full blown celiac to have a reaction to gluten which could still eventually destroy the nutrient absorbing capabilities of the intestines, hence the overeating. It might be possible that gluten in general is a toxic chemical, and that some people have a more severe reaction to it then others.

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  • About Me

    Celiac.com's Founder and CEO, Scott was diagnosed with celiac disease  in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. Scott launched the site that later became Celiac.com in 1995 "To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives."  In 1998 he founded The Gluten-Free Mall which he sold in 2014. He is co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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