Body Mass Index in coeliac disease

Weight after diagnosis

After being diagnosed with coeliac disease and starting a gluten-free diet, people may find that their weight changes. Some people may find that they put on weight more easily. This is because the lining of the gut heals, and the absorption of nutrients from food begins to return to normal. In addition, some people may feel so much better that their appetite improves and so they may start to eat more compared to before they were diagnosed. Conversely, other people may find that they lose weight possibly due to restrictions when following a gluten-free diet.

Recent research

In this study information was gathered from a database of people with coeliac disease at the Celiac Disease Centre of Columbia University in New York (from 1981 to 2007). The study included 369 people. The symptoms varied from one person to another, with 38% presenting with typical symptoms of diarrhoea and 62% with atypical symptoms with or without anaemia. The majority were of a normal weight (60.7%), 17.3% were underweight, 15.2% were overweight and 6.8% were obese. Generally those who were of a lower weight had more severe villous atrophy and were more likely to present with diarrhoea.

Once on the gluten-free diet the changes observed were as follows;

• Among people who were initially underweight, 42.4% became normal weight, 3.4% became overweight, and 1.7% obese.
• Of those people who were initially normal weight, 6.5% became underweight and 6.5% overweight.
• Of those people who were initially overweight, 16.7% became normal weight and 6.3% became obese.
• Among initially obese patients, 5.9% became overweight.

Research Findings

The research found that in most cases the gluten-free diet had a beneficial impact on BMI. Underweight people gained weight and generally overweight and obese people lost weight.

This recent study also supports previous research on BMI, indicating that many patients are not underweight at diagnosis but a significant proportion have a BMI of over 25. These findings should be considered when making a diagnosis of coeliac disease.

References

Dickey W, Bodkin S. (1998). Prospective study of body mass index in patients with coeliac disease. BMJ317: 1290

Cheng J, Pardeep S et al (2009) Body Mass in Celiac Disease: Beneficial effect of a gluten-free diet. Journal of Clinical Gastroenterology.