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  • Dr. Ron Hoggan, Ed.D.
    Dr. Ron Hoggan, Ed.D.

    Food Cravings, Obesity and Gluten Consumption by Dr. Ron Hoggan, Ed.D.

    Reviewed and edited by a celiac disease expert.

    Celiac.com 07/10/2006 - Increased consumption of gluten, according to Dr. Michael Marsh, raises the risk of celiac disease symptoms1. Although these symptoms may not indicate celiac disease, they reflect some biological realities. Grain-based foods simply do not offer the nutrients necessary to human health and they damage the human body. USDA and Canada Food Guides notwithstanding, if people eat grain-laden diets, they may develop symptoms of celiac disease (but in most cases, without the diagnostic intestinal lesion). The connection between eating disorders and celiac disease is well known and well documented2,3,4,5. Thus, the dynamics at work in celiac disease may offer insight into the broader realm of obesity, especially among those who are eating the recommended, daily quantities of grain-derived foods, while attempting to keep their weight down by eating low-fat foods.

    The primary, defining characteristic of celiac disease is gluten induced damage to the villi in the intestinal lining. Since malabsorption of vitamins and minerals are well known in the context of celiac disease, it should not be surprising that some celiac patients also demonstrate pica (Pica is an ailment characterized by eating dirt, paint, wood, and other non-food substances). Other celiac patients eat excessive quantities of food, coupled with a concurrent failure to gain weight. Yet another, perhaps larger, group of celiac patients refuse to eat (One may wonder if the latter find that eating makes them feel sick so they avoid it).

    Perhaps the most neglected group is that large portion of untreated celiac patients who are obese. Dr. Dickey found that obesity is more common than being underweight among those with untreated celiac disease6. When I ran a Medline search under the terms "obesity" and "celiac disease" 75 citations appeared. A repeated theme in the abstracts and titles was that celiac disease is usually overlooked among obese patients. While obesity in celiac disease may be common, diagnosis appears to be uncommon. Given the facts, I certainly believe that some of the North American epidemic of obesity can be explained by undiagnosed celiac disease. However, that is only a small part of the obesity puzzle, and I suspect that celiac disease may offer a pattern for understanding much of the obesity that is sweeping this continent.

    One example, a woman diagnosed by Dr. Joe Murray when he was at the University of Iowa, weighed 388 pounds at diagnosis7. Dr. Murray explained her situation as an over-compensation for her intestinal malabsorption. I want to suggest a two faceted, alternative explanation which may extend to a large and growing segment of the overweight and obese among the general population. As mentioned earlier, anyone consuming enough gluten will demonstrate some symptoms of celiac disease. If large scale gluten consumption damages the intestinal villi—but to a lesser degree than is usually required to diagnose celiac disease—fat absorption will be compromised. Deficiencies in essential fatty acids are a likely consequence.

    The natural response to such deficiencies is to crave food despite having absorbed sufficient calories. Even when caloric intake is huge, and excess calories must be stored as body fat, the need to eat continues to be driven by the bodys craving for essential fats. Due to gluten-induced interference with fat absorption, consumption of escalating quantities of food may be necessary for adequate essential fatty acid absorption. To further compound the problem, pancreatic glucagon production will be reduced, compromising the ability of the individual to burn these stored fats, while the cells continue to demand essential fats.

    Poor medical advice also contributes to the problem. The mantra of reduced fat continues to echo in the offices of health professionals despite a growing body of converse research findings. In February of this year, the results of a powerful, eight year study of almost 49,000 women showed little difference between the health of women consuming low fat diets when compared to those consuming normal diets8. Alarmingly, this low fat diet seems to have resulted in weight gain, a well recognized risk factor for a variety of diseases.

    For some of us, this result was predictable. The likely result of a low-fat diet is an increased intake of carbohydrates while food cravings are fuelled by a deficiency of essential fatty acids. If my sense of the underlying problem (caloric excess combined with essential fatty acid deficiency due to fat malabsorption at the microvilli) is accurate, then a low fat diet is exactly the wrong prescription. Many obese persons are condemned, by such poor medical advice, to a life of ever deepening depression, autoimmune diseases, and increasing obesity.

    At the end of the day, when these folks drop dead from heart attacks, strokes, or some similar disaster, the self-righteous bystanders will just know that the problem was a lack of willpower.

    I watched my mom steadily gain weight for 35 years. I watched her exercise more will power beyond the capacity of most folks. Still, she could not resist her compulsive eating. I have seen her take something from the freezer and chew on it while agreeing that she had just eaten a very large meal and should feel full.

    In December of 1994 I was diagnosed with celiac disease. According to the published experts in this area, my mom should also have been invited for testing. Yet, when asked for testing, her doctor refused her. Through persistence, and a pervasive faith in her son, mom finally (after months of negotiation) swayed her doctor to do the anti-gliadin antibody blood test. Despite the fact that she had been on a reduced gluten diet for the past year, her antibody levels were elevated.

    She never sought a biopsy diagnosis, and the EMA and tTG were not available here in Canada at that time. However, she has been gluten-free for the past seven years or so. She dropped a considerable amount of weight.

    Her weakness was never will power. She was battling an instinct so basic that few of us could have resisted. That, I think, is the story behind much of North American obesity. The widespread, excessive consumption of gluten at every meal, in addition to the low-fat religion that has been promulgated throughout the land, is resulting in intestinal damage and a widespread deficiency in essential fats is among North Americans.

    Ron Hoggan is an author, teacher and diagnosed celiac who lives in Canada. His book "Dangerous Grains" can be ordered at www.celiac.com. Rons Web page is: www.DangerousGrains.com

    References:

    • Marsh, Michael N. Personal communication. 2002.
    • Ferrara, et. al. "Celiac disease and anorexia nervosa" New York State Journal of Medicine 1966; 66(8): 1000-1005.
    • Gent & Creamer "Faecal fats, appetite, and weight loss in the celiac syndrome" Lancet 1968; 1(551): 1063-1064.
    • Wright, et. al. "Organic diseases mimicking atypical eating disorders" Clinical Pediatrics 1990; 29(6): 325-328.
    • Grenet, et. al. "Anorexic forms of celiac syndromes" Annales de Pediatrie 1972; 19(6): 491-497.
    • Dickey W, Bodkin S. Prospective study of body mass index in patients with coeliac disease. BMJ. 1998 Nov 7;317(7168):1290.
    • Murray, J. Canadian Celiac Association National Conference. 1999.
    • Howard BV, Van Horn L, Hsia J, et. al. Low-fat dietary pattern and risk of cardiovascular disease: the Womens Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006 Feb 8;295(6):655-66.

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    A very good article. I notice that when I eat gluten or other carbohydrates, I get addictive cravings. So I do think that macro nutrients along with the gluten are involved. I Couldn't agree with you more on the essential fatty acids.

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    Unfortunately, I have been fairly gluten-free for the past 2 years, and I have been packing on the pounds like never before. Help - I'd love some feedback.

    I must agree with Nicqizi, I to have been packing on the weight and it just does not end. I work out and eat healthy. I've never had a weight problem before. I wish that someone out their can tell me why the weight keeps coming and when will it stop. I feel more depressed now than when I was sick and found out that I was celiac.

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    I think this is a very logical explanation for obesity. However, I am anorexic and I just found out I have celiac disease. Somehow the two are related but there is the very strong psychological portion of the eating disorder that is present. I don't think celiac disease causes anorexia nervosa. Interestingly though, I have both anorexia nervosa and celiac in my family background. I have been looking for more research on this and I can't find a lot. It is mostly about celiacs who become anorexic. There must be some component to the anorexia though, or else everyone who was celiac would becaome anorexic. I would be interested to find out any more information.

    You may have been reacting to the effects of celiac at a very young age and not have even been aware of it. I have been watching my daughter waste away and not grow like the rest of her peers. For two years, I pressed her Doctors, I knew she had this disease. Finally at age 8 and after seeing two Pediatric GI's she was diagnosed. Her eating behaviors could only be described as anorexic and mealtime was always a battle. She never had the typical stomach issues that are classic celiac symptoms. Her "normal" reaction to eating food was a stomach floating sensation. She associated this feeling with food and stopped eating. I had know idea she was experiencing a physical reaction to food because at her age it had always been this way and she never thought to share it with me. I definitely see how this disease has impacted her eating habits. For anyone who wants to dismiss the impact of celiac disease and following a gluten free diet, my now nine year old daughter has grown four inches in one year. Which is startling when you consider she hadn't grown an inch for the two years prior to her diagnosis. I was just tested myself and my blood work just came back positive. I didn't think I could have this disease because I am about 40 pounds overweight. Go figure.

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    I found this article informative and well-written. As an individual with gluten sensitivity and a constellation of attendant problems (morbid obesity, hypoglycemia, cognitive impairment, ADD, chronic, treatment-resistant depression, excema and hives, just to name a few) I found conventional 'dieting' plans (such as Weight Watchers) an easy way to actually gain weight, instead of losing it. It wasn't until I removed from my diet all wheat and 'white stuff'-- white flour, sugar, white rice, and the like-- that I began to lose weight. During the first four months on a restricted food plan I lost 40 pounds. I also experienced extreme withdrawal-- quitting cigarettes was a walk in the park compared to this. Headaches. Cravings. Flu-like symptoms. And mood swings? I felt like I'd had all my skin ripped off and was walking around with all my nerve endings exposed. I was irritable, angry, or sad for no reason. Holding a simple conversation was an ordeal. I wouldn't wish it on my worst enemy, When withdrawal eventually ended, the weight loss didn't. I lost 103 pounds in 18 months, and for almost two years until, I spectacularly 'fell off the wagon' (it involved half a sheet cake-- don't ask), kept it off. It took almost three years, and 100 pounds regained, to reestablish a steady footing on the food plan (worked out with a nutritionist) but the weight gain (100 pounds) stopped and I have started to lose (20 so far) again. But the gluten-free diet is key to having no food cravings to distract me, and keeping my brain clear. Mr. Hoggan has addressed an under served audience with this article.

    I have been diagnosed with hypoglycemia, morbid obesity, anxiety disorder, severe eczema and rosacia. I feel at times like I have ADD and lack of concentration. I always feel tired and suffered on and off from diarrhea and abdominal pains. Your story is eerily mirroring my experiences so I am going to get checked. Thank so much for the honesty.

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    Unfortunately, I have been fairly gluten-free for the past 2 years, and I have been packing on the pounds like never before. Help - I'd love some feedback.

    Nicqizi, based on conversation with my doctor and nutritionist, along with personal research, eating a "fairly gluten-free" diet is simply not helpful. Your gut has to heal, all those villi need to grow back. Having something even once a month is not okay for someone who should be on a gluten-free diet. While I am no expert on how this relates to weight gain, I know that your gut cannot heal and the rest of your body will not function properly until you cut out gluten completely. Personally, I've also had to cut out dairy. Though I said I could never stop eating cheese, my body is grateful that I have!

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    THANK YOU so much for this article. I discovered my gluten intolerance a few years ago when I became a vegetarian in an attempt to feel better. I got SO sick eating 1,200 calories a day- a strict diet of organic home made breads, pastas and fresh fruits and veggies and fresh juices. I finally researched my symptoms (distended stomach, weakness, clouded thinking, bouts of depression and anxiety, inability to loose weight, muscle tension/spasms) and I heard about celiac for the first time.

     

    I cut gluten out completely and within days the clouds started to clear for me. Since then, I've also had to cut out most other grains, and now dairy as well. I still have relapses, but I don't beat myself up as much since I now finally understand the addictive component. *** I have found a HUGE hindrance on this journey back to health has been hidden MSG which many gluten free and 'health' food is full of (it can slip past even the most ardent label readers) For those of you who have commented that you are still continuing to gain weight even on a strict gluten free diet- check the labels- you may be eating food that, while labeled gluten free- is spiked with 'flavor enhancing' chemicals which are incredibly addictive and will leave you feeling just as compulsive, out of control and sick. Google "other names for MSG" and see if you don't find a connection. And good luck!

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    Exactly. I am gluten sensitive - I didn't know this for years, and throughout two pregnancies went through the horrible experience of feeling both sick and hungry all the time. Put on lots of baby weight as my body fought to absorb the necessary nutrients. There seem to be few studies of pregnancy while undiagnosed celiac.

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    I am a woman in her twenties who suffer from anxiety and OCD.

    A couple of years back I started bingeing from time to time, and it became increasingly frequent. A few months ago I actually started purging because I was so uncomfortable after stuffing myself with bread, cereal and crackers for the most part.

    Looking back last summer, there was a period of 15 days where I only ate meat and veggies. My mood was significantly better and my compulsions decreased by a lot.

    I am going to try very hard to go 2 weeks without gluten and see where it takes me. Fingers Crossed!!

    Thank you for the wonderful article.

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    I've been tirelessly researching this disease for almost two years. All of the skin issues that come with it, allergy to gluten and common allergy to dairy are markers for something. I once read that allergies come from the liver. Maybe we should all try a liver cleanse and see if we feel better?

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    At age 50 I finally discovered that what was making me sick is gluten, dairy and sugar. I used to stalk my GP with a variety of symptoms, ranging from dizziness, bloating, vision problems, constipation, severe joint pain (without swelling), fatigue, food allergies, shortness of breath, asthma and the list goes on ... I am certain there was a big "H" on my medical chart for hypochondriac. Since going on a gluten free lifestyle I have dropped 25 kg without trying. I am no longer hungry after meals and the cravings have gone. I feel 30 years younger. I have lots of energy. Just sorry I didn't realize it sooner and that neither the medical profession did.

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    I am in the process of looking for this very answer. I have celiac, fibromyalgia and Hashimoto's. I actually had a gastrointestinal doctor tell me last year that he didn't believe I had celiac because "celiacs are usually thin" (I'm 5'4" and weigh about 200lbs). The last time I was able to lose a significant amount of weight was in my late 20s when I eliminated refined carbs and sugars from my diet. No white stuff, cereal or breads and even though I didn't know it at the time, most of that was the gluten I consumed. I am now diagnosed with malnutrition and have been living very ill for the past several months. This article gives me hope that if I eliminate these things I can lose weight again and begin to feel more normal. I will check back and let you know how I'm doing soon.

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  • About Me

    As co-author of "Dangerous Grains" and "Cereal Killers", the study of the impact of gluten continues to be a driving passion in my life. I am fascinated by the way that gluten induces illness and impedes learning while it alters mood, behavior, and a host of other facets of our existence. Sure, the impact of gluten on health is an important issue, but that is only the most obvious area of impact. Mood disturbances, learning disabilities, and the loss of quality of life due to psychiatric and neurological illness are even more tragic than the plethora of physical ailments that are caused or worsened by gluten. The further I go down this rabbit hole, the more I realize that grains are a good food for ruminants - not people. I am a retired school teacher. Over the last decade, I have done some college and university level teaching, but the bulk of my teaching career was spent working with high school students. My Web page is: www.DangerousGrains.com

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