It is a myth that most coeliacs are underweight. The truth is that you could be underweight, normal weight or overweight and still have coeliac disease.
Historically, doctors would only think about testing you for coeliac disease if you presented with the classic symptoms of failure to thrive as a child, or being underweight with diarrhoea and possibly abdominal pain. That is still the case in a lot of clinics now.
But, many coeliacs are not underweight and don’t have those symptoms at all, quite the reverse – I see far more weight gain and constipation problems than the reverse.
A study by Dickey in 2006 in fact looked at the BMIs of 371 recently-diagnosed coeliacs and found the smallest group were actually underweight, most normal and many overweight or obese:
Seventeen patients (5%) were underweight (BMI < 18.5), 211 (57%) were normal, and 143 (39%) were overweight (BMI > or = 25), including 48 (13% of all patients) in the obese range (BMI > or = 30.0)
Their concern was that following a traditional gluten free diet inevitably enabled the villi to heal to some degree. This increase in absorption of nutrients resulted in over 80% of patients gaining weight over a two year period. Even the ones struggling with weight already. Yikes.
This is a case for making sure that you follow a truly healthy gluten free diet and don’t just swap rubbish gluten foods for rubbish processed gluten free ones.
Remember I talked about the ‘gluten whiplash’ phenomenon too – this describes people switching to gluten free alternatives, most of which contain maize, sugar, fat, salt, additives – anything to make it ‘normal’ and for us to like it – and people can become more sensitive to the other non-traditional gluten free grains, like maize and rice, because they are eating a lot more of them. In other words, they feel great on the gluten free diet for a while, then boomerang back to feeling ill again, because of the increased intake of other non-traditional gluten grains. It doesn’t happen to everyone, of course, but if you happen to have true gluten sensitivity and coeliac disease, it may well. Current estimates are that 1 in 10 people have some form of gluten sensitivity – that’s far higher than the estimates for coeliac disease and you can have both.
My advice is to use a gluten free diagnosis as a real opportunity to overhaul your diet and lifestyle; to eat more healthily than you ever have before and encourage your body to heal, not just bob down the freefrom aisle picking often unhealthy gluten free substitutes.
One other point is that sometimes a gluten sensitive can appear fat and obese but actually part of the way their gluten issue presents is as an intestinal bloating or fluid swelling problem. More on this tomorrow for you… for now, I just got this promised daily post in before midnight – phew!