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Normal Weight or Overweight People Can Also Have Celiac Disease

Can people with celiac disease be of normal weight? Photo: CC--Tony Alter 05/18/2016 - Common clinical wisdom, and some data, indicate that patients with celiac disease are likely to be underweight. However, data from west suggest that anywhere from 8% to 40% of celiac patients can be overweight or obese.

What about normal weight? Can people with celiac disease also have normal body weight? A research team recently set out to determine if people with celiac disease can be normal weight. The research team included I Singh, A Agnihotri, A Sharma, AK Verma, P Das, B Thakur, V Sreenivas, SD Gupta, V Ahuja, and GK Makharia.

They are variously affiliated with the Department of Gastroenterology and Human Nutrition, the Department of Pathology, the Department of Biostatistics, and the Department of Gastroenterology and Human Nutrition at the All India Institute of Medical Sciences in Ansari Nagar in New Delhi, India.

To answer that question, a team of researchers recently reviewed data on body mass index (BMI) of patients with celiac disease so they could correlate BMI with other celiac characteristics. For their retrospective study, the team reviewed case records of 210 adolescent and adult celiac patients who were seen at the team's Celiac Disease Clinic.

To classify BMI as underweight, normal weight, overweight, or obese, they used the Consensus Statement for Diagnosis of Obesity, Abdominal Obesity and the Metabolic Syndrome for Asian Indians for those with age >18 years and revised Indian Association of Pediatrics BMI-for-age charts for those between 12 and 18 years.

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Their results showed that, of 210 patients, 115 patients were normal weight, while 76 patients were underweight, 13 were overweight, and 6 were obese. There was no difference in the proportion of underweight between male and female patients with celiac disease.

The mean age of underweight patients was similar to those who were normal or overweight. Regardless of weight, there was no difference between any of the patients in terms of average duration of symptoms; frequencies of diarrhea, anorexia, and weakness; anemia; titer of anti-tissue transglutaminase antibody; and severity of villous atrophy in those with underweight or normal weight or overweight.

Of the celiac disease patients in this clinic, only one third of patients with celiac disease actually had low BMI. More than half had normal BMI, while the rest were either overweight or obese.

Physicians should not discount the possibility of celiac disease based solely on BMI. Patients with normal and high BMI can also have celiac disease.

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6 Responses:

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said this on
23 May 2016 12:21:10 PM PST
I was a normal weight person before my diagnosis and was very worried that after I went on the GF diet, my weight would start creeping up. Luckily it didn't. It would be interesting to see what the symptoms of the various weight groups are. My only symptom was anemia - no gastric distress, skin conditions, calcium deficit or mental/emotional aberrations. Despite the anemia I was very active and energetic. I can imagine that those with more severe symptoms might tend to be those who were underweight?

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said this on
24 May 2016 1:56:58 AM PST
I'm inclined to think that overweight celiac patients bodies urge them to eat more to counteract the malabsorption of nutrients.

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said this on
24 May 2016 5:15:56 AM PST
Very good info and review, as always, big fan here.

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said this on
24 May 2016 6:26:02 AM PST
I wish more doctors would get the message. I was turned down for testing because I am overweight.

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said this on
24 May 2016 6:57:36 AM PST
I was overweight since early childhood, suffered symptoms since a baby. Gastrointestinal symptoms, predominately, and anemia (doctors said it was because I was a woman) until I became obese in my 40's. I then began having neuro symptoms, and signs of dementia. I had memory loss, forgetting how to add and subtract, or I would be driving and all of a sudden not know where I was, as well as muscle/soft tissue and nerve damage by 48 when I was finally diagnosed. Doctors insinuated I was eating way too much food as the reason for my having celiac but not being underweight. I am finally, after 15 years GF, nearly a normal weight. I believe my body went into starvation mode, shoving everything it could into fat due to malnutrition. I never ate a lot. In fact, I ate little. I was very active, as well, until my body just seemed to begin to completely break down from lack of nutrition. I am glad researchers are finally seeing that not all people will present as underweight. I believe my obesity was actually a symptom of having a celiac caused metabolic problem.

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said this on
24 May 2016 7:52:19 AM PST
I was obese upon diagnosis. I had gained weight for no reason for years--started with 80 pounds in 6 months without explanation, and the other symptoms crept in. Suffered extreme urticaria, incredibly painful and itchy plaque type rashes, dermagraphia on my face, severe migraines, severe malabsorption, would go days forgetting to eat and low caloric intake on days I did eat--no appetite & no hunger, chronic fatigue and insomnia, extreme joint pain, mood swings mimicking bipolar disorder, toward the end (before diagnosis) severe memory issues, very high levels of inflammation evinced by my SED rates, chronic hives, debilitating allergic symptoms year-round to, it seemed, everything, thinning hair... you name it, I was the poster child for celiac symptoms EXCEPT for the weight gain. I was discounted for over a decade by various doctors until I found a doctor who looked at the rest of the symptoms and ordered the biopsy: surprise--positive for celiac. I am gluten free, and TOTALLY symptom free, for 9 years now.

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