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  • Jefferson Adams
    Jefferson Adams

    Should Patients With Morbid Obesity be Tested for Celiac Disease Before Surgery?

    Reviewed and edited by a celiac disease expert.

    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.

    Photo: CC--fbellonA 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 researchers included Federico Cuenca-Abente, Fabio Nachman, and Julio C. Bai of the Department of Surgery and Department of Medicine at Dr C. Bonorino Udaondo Gastroenterology Hospital in Buenos Aires, Argentina.

    They reported on the cases of five morbidly obese patients diagnosed with celiac disease during preoperative work-up for bariatric surgery. Celiac disease was suspected upon routine upper endoscopy, and confirmed by histology and positive celiac disease-specific blood tests.

    Interestingly, four of the five patients had no obvious symptoms. One complained of chronic diarrhea and anemia. All patients began a gluten-free diet. Due to their celiac disease diagnosis, doctors offered all five patients a purely restrictive bariatric procedure. At the time of the report, three of the patients had received a sleeve gastrectomy, while the other two were still undergoing pre-operative evaluation.

    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.

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    Very little real info here... celiacs can gain large amounts of weight due to inflammation. Constant hunger since they can't get nutrition from their food and overeating due to exhaustion and depression.

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    When I was diagnosed with celiac disease, I was overweight. I would have never thought that it was causing my increased weight. I wasn't eating too many processed products either but wheat, regular oatmeal, etc. was in my diet. As soon as I went gluten-free, I lost the extra weight. I think this is good advice for obese patients because most would never think to have themselves tested. There is a stigma that people with celiac disease are super thin. Being overweight itself is a form of malnourishment. If changing to a gluten-free diet can help morbidly obese people with celiac disease lose weight, then this is a great alternative to surgery. I tried to lose weight for many years before my diagnosis with no luck. Being healthy was more important to me and still is, but the extra weight lost was a plus and helped my health as well.

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    Very little real info here... celiacs can gain large amounts of weight due to inflammation. Constant hunger since they can't get nutrition from their food and overeating due to exhaustion and depression.

    Yeah, I know I shrugged with my weight and I don't over eat a ton of food, but I was often hungry and eating also gave me some energy.

     

    Now that I got some control, I still feel not so good, but at least it is not like death warmed over now.

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    Guest Susan Copeland

    Posted

    My daughter was obese. We didn't know at the time that she shouldn't be eating gluten. She finally underwent gastric bypass surgery. The doctors told her after the surgery that they could see that her small intestines were inflamed, but they went ahead with the surgery. She then lost a lot of weight. After that, she developed oral cancer and died in 2008. I believe that if a local doctor had tested her and told her she shouldn't eat gluten ahead of the surgery she might have listened. They should test first by all means. It might have saved my daughter. I had her tested by Enterolab after the surgery, and the test was positive but her local doctor did a blood test and said she was fine with gluten. She believed the local doctor. I did not, but since my daughter was an adult there was nothing that I could do. I hope this story helps others.

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    I face a quandary here in that I was diagnosed with celiac disease after suffering severe diarrhea and a 10 pound weight loss in one week. All the proper testing proved the diagnosis, and I went on the gluten-free diet immediately. That was in 2004. Since then, I also suffer spinal stenosis, fibromyalgia, osteoarthritis, and a knee replacement in 2011. All of which have contributed to a 40 pound weight gain. I had recently lost 14 pounds, but have gained all back with a probable Hypothyroid problem rearing it's ugly head. And I hate it!!!! The medications to relieve the pain, including epidurals every 3 months, caused side effects including weight gain. So you add medications on top of a gluten-free diet which according to the foods one chooses to eat can be dense (sugars, natural grains to make bread,etc.,) and weight gain becomes a big problem. Going on the so-called "Cave Man Diet" does not guarantee weight loss especially when it is difficult to digest enough of vitamins, minerals, and other natural elements to help us to survive. Like the vitamin D3 deficiency that is common in those of us who have celiac disease. It's a fine dance we dance just to live. My only hope is that the trials for the gluten-free pill that shows really good success in helping to allow people to eat wheat, (I won't say cure, yet) will be released sooner than later. Maybe next year........ I would really like to remove celiac disease from my bucket list!!!!!!!!

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    I have Hashimoto's thyroid disease, and after experiencing symptoms of gluten intolerance, I went on a gluten-free diet. At the time, I was not seriously obese but about 30-40 pounds overweight. Since then, and this was nearly a year ago, I have lost not so much weight, but volume, especially in the thighs and waist area. As with Kristie, it was more important to me to be healthy and symptom-free than to lose weight. Apart from obese adults getting tested for celiac disease/gluten intolerance, maybe it would also be a good idea for overweight children.

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    I face a quandary here in that I was diagnosed with celiac disease after suffering severe diarrhea and a 10 pound weight loss in one week. All the proper testing proved the diagnosis, and I went on the gluten-free diet immediately. That was in 2004. Since then, I also suffer spinal stenosis, fibromyalgia, osteoarthritis, and a knee replacement in 2011. All of which have contributed to a 40 pound weight gain. I had recently lost 14 pounds, but have gained all back with a probable Hypothyroid problem rearing it's ugly head. And I hate it!!!! The medications to relieve the pain, including epidurals every 3 months, caused side effects including weight gain. So you add medications on top of a gluten-free diet which according to the foods one chooses to eat can be dense (sugars, natural grains to make bread,etc.,) and weight gain becomes a big problem. Going on the so-called "Cave Man Diet" does not guarantee weight loss especially when it is difficult to digest enough of vitamins, minerals, and other natural elements to help us to survive. Like the vitamin D3 deficiency that is common in those of us who have celiac disease. It's a fine dance we dance just to live. My only hope is that the trials for the gluten-free pill that shows really good success in helping to allow people to eat wheat, (I won't say cure, yet) will be released sooner than later. Maybe next year........ I would really like to remove celiac disease from my bucket list!!!!!!!!

    I have always led a healthy lifestyle, but still suffered from many symptoms. I was diagnosed only 4 years ago. Little did I know that all that whole wheat was killing me. I have been on a strict gluten free and meat free diet and I still gain weight. I don't eat junk food, soda, or any gluten-free products such as breads, cookies, etc. I am also thinking of just doing the cave man diet, but I am probably close already. I don't know what to do. I will continue to research regarding weight gain and celiac disease.

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    I have always had a weight problem. In my thirties, after tipping the scale at 344 lbs, diabetic with high blood pressure and high cholesterol, I went through the roux-en-y gastric bypass. The first several weeks that I was only allowed liquids, the weight came tumbling off, eighty pounds. It was when the doctor gave the go ahead to eat solid foods that my weight loss came to a crashing halt. I was told that a half sandwich was acceptable for a meal as long as it was whole grain bread. Slowly, I watched with dismay as the weight loss not only stopped, but started creeping back on. The doctor was convinced I wasn't following the eating plan, even though I was. Ten years later, I'm still sixty lbs lighter than I was, but still feeling horrible. I was just tested for celiac three weeks ago. It's positive. I'll never forget going to a doctor several years ago and posing the question to her whether I could be celiac. She literally laughed at me and said, "No, that's not possible." I'd love to see her face now. I've been faithfully following a gluten free diet since, and so far, seven lbs have slipped off without a hitch. My advice: ANYONE who suspects they might have a problem with gluten, push your doctor to test you. I wish I had pushed sooner... I may never have had the surgery, and I probably wouldn't have the diabetes, arthritis, low thyroid, anemia, etc that I have developed over the years. Excellent article, and confirms my experience to a tee.

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  • About Me

    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 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. 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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