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Higher Body Mass Index and Lower Risk of Obesity in Celiac Disease Patients on a Gluten-free Diet 05/25/2012 - A team of researchers recently set out to examine body mass and obesity risk in a large population of people with celiac disease who are following a gluten-free diet.

Photo:CC-FBellonThe research team included T. A. Kabbani, A. Goldberg, C. P. Kelly, K. Pallav, S. Tariq, A. Peer, J. Hansen, M. Dennis & D. A. Leffler. They are affiliated with the Department of Medicine and Division of Gastroenterology at Beth Israel Deaconess Medical Center in Boston, Massachusetts.

Diagnosis for celiac disease is on the rise, and many people who are diagnosed experience weight changes once they adopt a gluten-free diet. There's a pretty good amount of study data on weight change on a gluten-free diet, but a very limited amount of data regarding changes in body mass.

The researchers wanted to look at a large population of people with celiac disease, who followed a gluten-free diet to better understand changes in body mass index (BMI) following celiac diagnosis.

To do this, they looked at a total of 1018 patients with biopsy confirmed celiac disease. The patients had all previously visited the Beth Israel gastroenterology clinic in Boston.

The team recorded data for initial and follow-up BMIs, and used an expert dietitian to assess patient compliance with a gluten-free diet. They found a total of 679 patients with at least two recorded BMIs and GFD adherence data, and used data from those patients in their study. The average amount of time from first BMI measurement to follow-up measurement was 39.5 months.

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When they compared the results against data for the general population, they found that celiac disease patients on a gluten-free diet were significantly less likely to be overweight or obese (32% vs. 59%, P < 0.0001).

They also found that average body mass increased significantly after patients adopted a gluten-free diet (24.0 to 24.6; P < 0.001). Overall, 21.8% of patients with normal or high BMI at study entry increased their BMI by more than two points.

The results of this study show that celiac disease patients on a gluten-free diet have lower BMI than the regional population at diagnosis, but that BMI increases with a gluten-free diet, especially in those who follow the diet closely.

Still, even though overall risk of obesity is lower than the regular population, once celiac patients adopt a gluten-free diet, 15.8% of patients move from a normal or low BMI class into an overweight BMI class, and 22% of patients overweight at diagnosis gain weight.

As a result, the study team feels that weight maintenance counseling should be an integral part of celiac dietary education.

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14 Responses:

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said this on
25 May 2012 1:54:50 AM PST
This article is an unnecessary obesity scare tactic. BMI is bunk, so this article has no merit. It doesn't mention that half of adults are overweight at diagnosis (because it would nullify this study).

said this on
25 May 2012 2:34:29 PM PST
We actually covered that research as well:

I wouldn't say this research is any sort of obesity scare tactic though. It just shows that we still don't entirely understand how celiac disease affects the body, particularly body weight.

Don Brown
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said this on
29 May 2012 11:06:55 PM PST
Hi all, well perhaps my personal experience may help. I self-diagnosed gluten sensitivity about 2 years back. My weight at that time was 234. My weight today is 234... changes. Yep, after removing all wheat products my body size started to change; it was almost to 3x. After 6 months, my size overall dropped to a large. I lost no weight but I felt much better. I'm 61 now and am at a size that feels better. I will start to lose some pounds soon, diet changes, but body mass dropped like a rock when I started eliminating wheat. Maybe others have had similar results. Have a good one.

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said this on
12 Jun 2012 5:05:17 AM PST
So far, I've only been gluten-free (self-diagnosed celiac disease) for two months, and I have had similar results. Over the first month I decreased one dress size in volume though my weight stayed the same. As gluten-free bread, etc. is in general higher calorie, if the same amount is consumed after going gluten-free then weight is bound to rise. I'm 64 and feel so much better since going gluten-free. I would like to lose about 5 kilos eventually but will wait until I have been 6 months gluten-free to evaluate the changes. I find that I eat less bread, biscuits, etc. than before as the gluten-free ones are more filling and unless home-made, not very nice.

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said this on
28 May 2012 6:37:15 AM PST
I don't understand the body mass index. All I know is that my waist and stomach keep getting bigger and I can't seem to lose any weight.

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said this on
28 May 2012 10:49:38 AM PST
How come it doesn't mention that gluten-free food is way higher in sugar and fats to make food more palatable?

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said this on
28 May 2012 7:14:42 PM PST
This may speak, in part, to the higher fat and calorie content present in many of the gluten-free breads/baked goods.

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said this on
28 May 2012 8:42:25 PM PST
I was diagnosed with non-celiac gluten sensitivity 6 months ago at age 64. No gluten since then, very few other grains, and barely any desserts, yet my weight stays unchanged at slightly overweight. Given the change in my eating habits, I'm astounded that I haven't lost weight. My experience parallels that of the research subjects.

I wonder what the metabolic explanation is for persistent weight gain despite being gluten-free.

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said this on
29 May 2012 8:40:37 AM PST
I was relieved to read this article. I was diagnosed 2 years ago with celiac disease, and after adapting to a gluten-free lifestyle, my weight jumped a lot. I have tried every diet and cannot seem to lose weight, the belly fat has really increased and I work out daily. I was glad to hear there are others who are struggling with this as well. Thank you for printing the study!

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said this on
29 May 2012 10:03:19 AM PST
Learning, Learning, Learning. Thanks for the
info. And yes, I'm one who was found to be
overweight from celiac disease after 20 years, but I have
definitely benefited from the gluten-free diet.
Thanks again!

BK Simmons
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said this on
29 May 2012 12:59:47 PM PST
I would have liked a little info on how the gluten-free diet, which adds more "bread, rice, & other starches" into a celiac's diet causes a weight gain especially when their previous diet has limited these foods. Also how the medication(s) used in the management of the disease affects the weight gain.

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said this on
31 May 2012 1:58:21 PM PST
For those who haven't lost any weight, maybe you aren't eating enough food? It's important to fill your diet with healthy proteins and those grains that you are able to eat. For me, I eat a jumbo egg and veggie omelet with one corn tortilla, sprinkling of cheese, and salsa in the morning. Lunch is usually chicken with a green salad with some sort of nut and olives and a healthy dressing. Dinner is about the same: a healthy protein, lots of veggies, and a carb that I can handle. I've also done the 4-6 small meals a day when I have time. Gluten-free doesn't necessarily mean diet food. You still have to eat wisely and think portion-control. Which is why the eating small meals every 3 hours really is best.

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said this on
12 Jun 2012 5:09:17 AM PST
I totally agree with you, Renee.

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said this on
05 Sep 2013 10:44:16 PM PST
BMI is a defunct concept devised in the early 1800's. I am 5' 8". At the peak of my season my senior year in high school, I did three workouts per day 5 days a week and one long workout on Saturdays, swimming over 11,000 yards a day. I had a 29-30 inch waist, weighed between 165 and 170 lbs and had a body fat level of about 4% (too low really). I was not a runner but I could run for 7 miles non-stop, take a short break and then run 7 miles back home. You could not pinch any fat on my abdomen. It was skin over muscle. At age 45 I turned to lifting. I worked out 4-5 days a week, could bench press 325 lbs and squat 465 lbs. I had a 31-32 inch waist, weighed between 185 and 190 lbs and a body fat level of less than 10%. I could probably run about 5-6 miles one way. You could pinch a little bit more than skin on my abdomen, but I looked "cut" all over.

According to the BMI chart, at 190 lbs, I was officially obese. Nonsense! I was in excellent condition. (I wish I was back there now.) If I followed their suggested weight level for a "normal" person, I would only weigh about 140 (or even less); that's Auschwitz material. The only proper way to determine a healthy weight for any given person is according to their LBM - lean body mass. Lean Body Mass is a component of your body composition, calculated by subtracting your body fat weight from your total body weight: total body weight is lean plus fat. Lean Body Mass equals Body Weight minus Body Fat. The correct rule should be: It's not how much you weigh, its how lean or fat you are. If you weigh 200 lbs and are 5' 8" but are only 10% body fat and you can jog/run 5+ miles without straining, chances are you're in great shape and great overall cardiovascular health.

A toned and/or muscular body is both healthy and attractive. Being an emaciated scarecrow is not. And for the record, I have celiac disease. Watching what and when you eat certainly helps, but nothing can take the place of a proper exercise/workout regimen. No diet in the world can make you look tone or muscular, only exercise can do that.

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