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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

    User Feedback

    Recommended Comments



    Well written and informatve.

    My God, thank you for this article. I've lost 130 lbs. on a low carb food plan but recently had pancreatitis, which has made it very difficult to eat my raw veggies, so I've been substituting them with wheat germ for several months. Consequently, I have gained 35 lbs. back with no explanation since my caloric intake remains around 1,100 cals/day.

     

     

    I have had many of the illnesses you have throughout my life (including the bone spurs!), gallbladder removed, pancreatitis because I still produce gall stones that get stuck in my bile ducts, pneumonia, low Vitamin D levels, Raynaud's Disease, ad infinitum.

     

    I have been at my wit's end trying to figure out what's wrong (why I'm gaining 4-5 lbs. per month), been tested for Cushing's (negative), thyroid levels (erratic). I have Hashimoto's thyroiditis, and my levels are swinging from one end to the other.

     

    I'm going to have my GI doc do an ATA test and will immediately discontinue eating wheat germ and substitute for other cooked vegetables and PRAY the weight gain stops! I've been so depressed, tired, and mentally lethargic that I've just wanted to go to sleep and never wake up.

     

    You have given me hope for the first time in months!

     

    Again, thank you so much!

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    This is the most informative article I have read on overweight and celiac disease. But I was also told that you should be tested before you actually start the gluten-free diet because you may end up getting a false negative test if you have removed the gluten from your diet. My father-in-law was just diagnosed with it, he is 77 years old. Who knows how long he has had it, he got sick and they did routine blood work and his kidneys were failing. They ended up doing all kinds of tests and then finally did the celiac test and confirmed that was he whole problem. Recommended the rest of the family get tested. I'm not a blood relative in that sense but after reading your article here, I definitely fit the bill and will also get tested. I am a firm believer that the GMO wheat that is being fed to us is not helping things either. This is another reason we should push congress to pass a labeling law like they have in Europe. Actually, testing for celiac should be part of the routine blood work. I bet that would help many obese children of today. Maybe we need to ask for that too. God Bless You! I'm sure your article has helped a lot more people than who have posted.

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    I agree and have been on a gluten free diet for 8 months now. I'm Feeling much better and now that I finally have the energy to exercise I'm going to focus on weight loss.

     

    If you type in "gluten free restaurants" and the name of the city you live in you will find many options (depending on how big of a city) for eating out. Many pizza places now offer a gluten free crust and several Italian restaurants offer gluten free noodles.

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    This article is just plain AWESOME. I too am overweight and tested negative for celiac disease. However, my Mom and all her sisters have different autoimmune disease ranging from diabetes to lupus and my Mom has "IBS", which I think is really celiac but she won't listen to me. My first cousin is celiac and so is her daughter. I decided after doing all this reading to just go gluten free. After a few days I started to feel better. I'm now a month and a half in and I feel terrific. I haven't felt this good in years. The brain fog has lifted, I don't feel like I want to crawl back into bed after I get up in the morning and I've started losing a little bit of weight. (About 5 lbs so far). I really hope that continues. I myself also have PCOS and depression with anxiety. Here's hoping I can kick all those medications to the curb and that the weight continues to come off.

     

    Thanks so much for this article. It makes me feel good to know that its not in my head and that being overweight is indeed a symptoms of gluten intolerance/sensitivity/celiac. I will never go back to eating it again. I think I will get the genetic testing done though since I tested negative and both my daughters have ADHD.

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    Guest GF in Long Beach

    Posted

    Well written and informatve.

    I am celiac and have been off gluten for years but have been unable to lose any significant weight. Atkins diet works best for me so I am back to it but the constipation is a pain. In researching for constipation meds I looked up the use of inulin as fiber supplement and found out about Fructose Malabsorption. I had already surmised that fruits are a real issue with me since I still suffered from diarrhea even though I adhere to a strict no-gluten diet. It turns out that Fructose Malabsorption can go hand-in-hand with celiac disease. Please read more about this for yourself to help you better with your food choices.

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    I was diagnosed with coeliac disease 6 years ago after a nasty bout of pnuemonia, they didn't think I would make it and get better but I am here to tell the story. My sister had been diagnosed with coeliac disease and after being so sick asked to be tested and well was a definite positive, I too was always over weight and lost a lot of weight. I then went on to have my 3 children tested and my eldest whom was always just so little was diagnosed at the age of 11 or 12 he is now 18 has just thrived is now taller than me and is so healthy.

    Thank you for this article as I always wondered if coeliac disease had something to do with my weight issues.

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    Now I have hope I haven't had in years, me and my daughter have been so sick for years, with all these symptoms and no doctor would believe us or give us a diagnosis. I am going to change our diet and pray it's our cure!! We are both overweight too, and doctor said NO WAY you can be celiac you are fat and not malnourished. Wish she would read this articles and the responses.

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    My doctors told me I had IBS and after reading about gluten on the internet decided to cut it out and felt so much better doing so. I told my doctor and he did a blood test which was positive for coeliac disease. I also have an under active thyroid which was diagnosed about 12 years ago. I am now waiting for an appointment for a biopsy of my small intestine as recommended by my specialist. I am struggling to lose even a pound in weight despite eating healthy and exercising. I did the Atkins diet about 8 years ago, and felt great and full of energy. It finally makes sense why, and maybe I will try it again, although I did find it hard not being able to eat fruit as I usually eat a few pieces of fruit every day.

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    Thank you for posting info, especlially related to being over-weight and having celiac. The only time I've ever felt my best was when I strictly adhered to South Beach phase 1. Ironically, no gluten is in it. Hopefully, I can get turned around. Hopefully, my teen son with Asperger's will benefit from my example. He exhibits a lot of my issues, but my other child doesn't.

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    Thanks for the article and information, it really makes sense when you think about it. I have recently gone through some doctor appointments after a lifetime of digestive issues and slight weight issues, which both have gotten totally out of control in the past 4-5 years. In my own experience, I have learned that it is absolutely imperative that you find a doctor that's very knowledgeable and willing to listen to all your symptoms without calling you crazy. My doctors tested me for a thyroid issue (blood work all normal, even Hashimoto antibodies) and now are testing me for Celiac. But I learned that you have to be very persistent and tell the doctors ALL of your symptoms even if they seem crazy or unrelated to your problem because a LOT of doctors will try to push you off and attribute your symptoms to something else. If your doctor won't listen to you, he/she does not have your best health in mind! A good doctor is absolutely essential to pinpointing the problems.

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    I have been diagnosed with celiac disease recently and have started losing weight since going gluten-free and am worried about getting too thin because I wasn't terribly overweight before changing my diet!!! I wanted to share something really weird since eliminating gluten from my diet. I have had a problem wetting my pants since I was a young girl. I just got used to the fact that I would urinate in my underpants every time I sneezed or coughed (I am 41 now) well guess what??? I HAVE NOT wet my pants since I quit eating foods with gluten... I feel great even though I am losing weight. I think flour causes weight gain not fat and sugar.

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    I wonder why gastro doctors won't at least test folks with almost all the symptoms of celiac disease but are morbidly obese? I was told the Alcat test was bunk and they won't do any biopsies even though gluten-free eating stops most of my symptoms! Also my insurance won't pay for a consult with a dietitian without positive biopsy results. I guess I'm on my own here! Thank you so much for this article!

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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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