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  • Jefferson Adams
    Jefferson Adams

    Nearly Half of Patients with Celiac Disease are Overweight or Obese at Diagnosis

    Reviewed and edited by a celiac disease expert.

    Celiac.com 05/09/2012 - Weight loss is traditionally regarded as one of the classic symptoms of celiac disease. Recent studies suggest that people with celiac disease are far more likely to be obese than underweight at the time of presentation.

    Photo: CC--fbellonA research team recently set out to assess the frequency of obesity in newly diagnosed celiac disease.



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    The research team included Elizabeth Tucker, Kamran Rostami, Sudhakaran Prabhakaran, and Daivid Al Dulaimi. They are affiliated variously with the Institute of Health and Society of Worcester University, School of Clinical and Experimental Medicine in Worcester, the University of Birmingham, and the department of Gastroenterology at Alexandra Hospital in Redditch, in the United Kingdom.

    The research team wanted to assess the frequency of obesity in newly diagnosed celiac disease.

    To do so, they reviewed dietetic records and patient demographic of people with celiac disease, along with initial assessment date, and Body Mass Index (BMI) recorded and statistically analyzed.

    In all, they reviewed data for 187 celiac disease patients diagnosed between 1999 and 2009. Of those, 127 patients were female (68%) and 60 male (32%), a ratio of 2 to 1.

    Patients ranged in age from 18 to 87 years of age, with an average age of 54 years.

    BMI inter-quartile range (IQR) ran from 21.5 to 28.1, with an average BMI of 23.6. IQR was 21.8 to 27.3 for men, with an average BMI of 23.9.

    For females, the BMI IQR ran from 21.4 to 28.6, with an average of 23.2. Overall, 83 patients (44%) registered a BMI of 25 or above.

    The team found no significant difference gender, age or year of referral among patients with a BMI of 25 or above.

    Twenty-five patients (13 %) had a BMI of 30 or above. Of those, twenty were female, and ranged in age from 18 to 71 years old, with an average age of 56 years.

    In all, 11% of females registered a BMI of 30 or more, compared with only 3% males, a 5 to 1 ratio. Only 5 patients (3%) had a BMI below 18.5.

    They found that nearly half of those diagnosed with celiac disease registered with a BMI of 25 or over. Compared to males, females showed a wider range of BMI and were more likely to be obese, registering a BMI of 30 or more.

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    As someone recently diagnosed with celiac disease, I was actually glad to see this article. I have had active symptoms of this disease for about two years, and during those years I have steadily put on weight. I would love comments on people in the same situation and what they have done to get their weight back on track.

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    As someone recently diagnosed with celiac disease, I was actually glad to see this article. I have had active symptoms of this disease for about two years, and during those years I have steadily put on weight. I would love comments on people in the same situation and what they have done to get their weight back on track.

    My son is 18 and has been overweight most of his life. In 2010 we found out he was gluten intolerent. He is 6 feet tall and weighs 312 pounds. It has been my primary goal in life to help him lose weight. We record everything he eats and he works out at the gym at least 4 times per week. He rarely has an appetite and usually consumes 1800 calories per day...2000 on a good day. Does the gluten totally destroy the gut and the metabolism?

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    I, too, was overweight when first diagnosed - despite trying every diet going, and, really, not over-consuming in any shape or form. I also undertook regular exercise, but just kept gaining weight. On top of that I didn't have any classic symptoms of coeliac disease - I was the last person in my family to ever have 'digestive upsets'. True. But I did have a plethora of annoying and, up until that day unrelated, minor health issues. Then I had a violent reaction to an antibiotic and one of the many tests my doctor ordered was the blood test for coeliac. I laughed when she rang to tell me there was a possibility that I had coeliac disease. Wasn't that a condition of skinny, malnutritioned children? I was 48 and, well, fat! Further tests revealed major damage to my intestine and I immediately went gluten-free (I'm good at following diets), but to little avail. Nothing changed. After six months and some further research I chose to attempt the Specific Carbohydrate Diet, suspecting problems with Leaky Gut Syndrome. After a week of severe withdrawal symptoms, eating SCD became easy and I have now lost over 30kilos and have more energy and fewer health problems than I ever have in my adult life. celiac disease seems to impact people in so many ways... the image of the poorly child that I had is only one of them. Given the vast numbers of undiagnosed people we are told are out there, surely it is time for the education campaign regarding this disease to be stepped up?

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    My son is 18 and has been overweight most of his life. In 2010 we found out he was gluten intolerent. He is 6 feet tall and weighs 312 pounds. It has been my primary goal in life to help him lose weight. We record everything he eats and he works out at the gym at least 4 times per week. He rarely has an appetite and usually consumes 1800 calories per day...2000 on a good day. Does the gluten totally destroy the gut and the metabolism?

    Yes, this happened to someone I know. He needs to have all of his vitamins and minerals checked. He probably destroyed the lining of his stomach. He cannot absorb b12 through food. He has to get b12 shots; how long and how often will depend on if his stomach can repair itself. Also, the vitamins may need to be liquid and he will have to make sure they are gluten-free.

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    My sister and I both have celiac as does two of her three children. We had polar opposite symptoms. I was very skinny but my sister was obese. The more important information we need to understand is WHY, is there such broad spectrum of symptoms?

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    I have to put in my two cents. I have worked in health care for 7 years and have in that time seen an increase in the diagnosis of celiac disease. I have personally had a lot of health issues and at the age of 36 (2 months ago) I was diagnosed with the disease myself. Even though I work in the field I was in shock. I have had most of the symptoms for 20 years and never suspected because I'm overweight. No one would ever believe I'm malnourished. We need to spread the word. This isn't a skinny persons disease. When I tell people I have I frequently get looks of shock, disbelief, and have even had people accuse me of trying to get attention or making it up. If only they understood what I've gone through and how sick I've been for years. Please help me spread the word and educate people.

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    I too was gaining weight rapidly as I aged, gaining 20 lbs. in 2 years. When I told people I had celiac disease, they'd say "I thought that made you thin?" I'd joke back, "there's no wheat in candy!" Meanwhile, after 3 years almost, I've lost about 25+ and feel like I have my life back!

     

    Let me challenge readers here: stop cheating, you are killing your small intestine, which leads to other serious things. My mother died undiagnosed at 60. She had horrendous health, never felt good, and ended up with lupus, seizures, and liver failure. She always baked bread and rolls and was so ill she'd have to lie around. I teased her as a skinny teen calling her fat. My, don't we all have a lot to learn!

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    I have recently been diagnosed with celiac disease. After months of being ill, my first doctor dismissed it as a stomach bug and stress from my son dying. I was 140kg, which is why I could not have it according to my doctor, so i switched doctors and made him give me the blood test and biopsy. Low and behold... he explained to me that I was so overweight because I was not getting the nutrients I needed, which is why i was so hungry and kept eating. I have been gluten-free for 9 months and I am down to 85kg. My periods went from a 29 - 75 cycle to 28, no more miscarriages (of which I have had 5), no more bad mood swings or feeling so exhausted I could barely get out of bed.

    Good luck to all, don't give up! Make your doctor do what you want, they do not have all the answers if they will not let you supply evidence!

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,500 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.


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    Scott Adams
    Celiac.com 11/29/2006 – Contrary to popular beliefs (not to metion outdated medical training), this study demonstrates that 39% of those who are diagnosed with celiac disease are actually overweight rather than underweight. A full 30% of celiac disease patients were in the obese range at the time of their diagnosis. Unfortunately many medical doctors still wont even consider testing overweight patients for celiac disease because they erronously believe that the disease can only occur in individuals who are underweight. This line of reasoning is outdated and incorrect, and is also very dangerous to those who happen to have celiac disease are are overweight—which is now known to be quite common.
    For those who want to read more about this topic be sure to have a look at the following articles:
    Celiac Disease and Obesity—There is a Connection by Melissa Croda Food Cravings, Obesity and Gluten Consumption by Dr. Ron Hoggan, Ed.D.
    Below is the Abstract for the latest study, which was conducted by William Dickey, M.D., Ph.D., F.A.C.G.:

    Am J Gastroenterol. 2006;101(10):2356-2359.
    Overweight in Celiac Disease: Prevalence, Clinical Characteristics, and Effect of a Gluten-Free Diet
    Posted 11/14/2006
    William Dickey, M.D., Ph.D., F.A.C.G.; Natalie Kearney, B.Sc. Abstract:

    Background: It is well established that a minority of celiac patients present with classic symptoms due to malabsorption. However, few studies have focussed on the distribution of body mass index (BMI) in celiac populations and its relationship to clinical characteristics, or on its response to treatment.
    Methods: We reviewed BMI measurements and other clinical and pathological characteristics from a database of 371 celiac patients diagnosed over a 10-yr period and seen by a single gastroenterologist. To assess response to gluten exclusion, we compared BMI at diagnosis and after 2 yr treatment in patients with serological support for dietary compliance.
    Results: Mean BMI was 24.6 kg/m2 (range 16.3–43.5). Seventeen patients (5%) were underweight (BMI Conclusions:
    Few celiac patients are underweight at diagnosis and a large minority is overweight; these are less likely to present with classical features of diarrhea and reduced hemoglobin. Failed or delayed diagnosis of celiac disease may reflect lack of awareness of this large subgroup. The increase in weight of already overweight patients after dietary gluten exclusion is a potential cause of morbidity, and the gluten-free diet as conventionally prescribed needs to be modified accordingly.


    Jefferson Adams
    Celiac.com 12/19/2011 - Very little data has been collected about how body mass relates to celiac disease in children in the United States. Recently, a team of researchers sought to document the way celiac disease presents in children with normal and with elevated body mass index (BMI) for age, and to study BMI changes in those kids following a gluten-free diet.
    The research team included Norelle Rizkalla Reilly, Kathleen Aguilar, Benjamin G. Hassid, Jianfeng Cheng, Amy R. DeFelice, Philip Kazlow, Govind Bhagat, and Peter H. Green. They are variously affiliate with Columbia University School of Medicine.
    The team reviewed data from patients treated at their specialty clinic from 2000 to 2008, for whom follow-up growth data available. In all, they evaluated 142 children from 13 months to 19 years in age, all with biopsy-proven celiac disease.
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    However, for overweight and obese children with celiac disease, the results indicate that a gluten-free diet may be helpful in lowering BMI.
    Source:

    JPGN 2011;53: 528–531


    Jefferson Adams
    Celiac.com 03/04/2013 - Morbid obesity is a common medical condition. In many cases, bariatric surgery is necessary. Although for decades celiac disease has been associated with chronic diarrhea and weight loss, and other classic symptoms, recent data shows that the clinical spectrum of celiac disease is extremely wide.
    A group of researchers recently reported on the benefits of diagnosing celiac disease during pre-operative work-up for bariatric surgery.
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    The team's findings help to enlarge the clinical spectrum of untreated celiac disease. Even though rates of celiac disease in obese patients seems to be similar to that in the general population, the team recommends that patients with morbid obesity be tested for celiac disease in order to determine the best surgical strategy and outcome.
    Source:
    Acta Gastroenterol Latinoam 2012;42:321-324


    Jefferson Adams
    Celiac.com 04/06/2015 - Several studies have shown that many patients with celiac disease experience changes in body weight after starting a gluten-free diet, but researchers still don't have much data on rates of metabolic syndrome in this population.
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    Source: 
    Aliment Pharmacol Ther. 2015;41(4):352-359.


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