Yes, Crohn’s disease can sometimes cause weight gain. But that link isn’t as widely discussed as that of the disease with weight loss, according to Brigid Boland, MD, a gastroenterologist, assistant professor of medicine at the University of California, San Diego, and spokesperson for the American Gastroenterological Association.
“Based on what we currently know, Crohn’s disease itself does not cause weight gain; however, there are likely several indirect ways in which weight gain could occur,” says Dr. Boland.
The most common factors linked to weight gain in people with Crohn’s disease include:
Medications and their side effects
Corticosteroids are often prescribed as a short-term solution to manage inflammation during a Crohn’s flare-up. They’re also a well-known cause of weight gain, says Alan Moss, MD, scientific director of the Crohn’s & Colitis Foundation and professor of gastroenterology at Boston University in Massachusetts.
“Steroids…can cause weight gain, and this is typical visceral weight gain around the skin. [abs] with changes in fat distribution, and also around the face,” says Dr. Moss. He notes that long-term use can also affect blood sugar and bone health. This is why gastroenterologists generally aim to keep people with Crohn’s disease on steroids for about four weeks at most to manage a flare-up.
Boland says long-term steroid use can decrease metabolism, increase appetite, and cause fluid retention, which can also lead to weight gain.
Moss says other newer medications, such as biologics, don’t cause weight gain. People who gain weight after starting biologic medications usually regain weight lost due to previous malnutrition or active disease.
Diet changes and food aversions
The inability to eat a balanced diet is another major obstacle that can trigger weight gain in people with Crohn’s disease, says Moss.
During a flare-up, it’s easy to turn to foods that are easier to tolerate but more likely to cause weight gain, like ultra-processed foods and refined carbohydrates. These habits may persist even after you achieve remission.
Some people tend to avoid eating healthy foods that cause symptoms during a flare-up, such as high-fiber foods and low-fat dairy products. During remission, they can add these foods back into their diet, but they often don’t because they’re afraid of another flare-up.
“No one ever tells them to re-evaluate what [they’re] eat and get back to a more balanced diet,” says Moss.
Fatigue and inactivity
When you have symptoms of Crohn’s disease, you may not have the energy to exercise. But inactivity and a change in diet can lead to gradual weight gain.
“If the combination of feeling unwell, low energy and eating highly processed foods [comes together]it’s a bad mix that will lead to excessive weight gain,” says Moss.
Stress and emotional eating
Illness-related stress can sometimes lead to changes in eating habits, including overeating or what appears to be emotional eating.
In other cases, some people may overeat after the flare-up is over and be able to eat safely again, says Chelsea Cross, RD, who is also a personal trainer in Kitchener, Ontario, Canada. Cross has Crohn’s disease and works with clients with IBD.
“Once clients begin to heal, [and] the medications help them feel better, but sometimes they eat too many high-calorie foods because many feel very restricted when they are sick,” she says.
Appetite found in remission
After successful treatment with medications or surgery leading to remission, appetite may return quickly and weight may rebound more quickly than expected.
Once you and your healthcare team develop a treatment plan that works, you may notice weight gain, an indication that you are on the right track. “Weight gain can be positive…medications reduce inflammation, allowing greater [nutrient] absorption, and so the person is healthier,” Cross says.
:max_bytes(150000):strip_icc()/VWH-GettyImages-1263892776-862077d3818749729a4156a3b45a0543.jpg?w=390&resize=390,220&ssl=1 "Are apricot seeds sure to eat?")
