Does coeliac disease cause weight gain?

Liz Wood Alphabiolabs

By Liz Wood, Health Testing Specialist at at AlphaBiolabs
Last reviewed: 20/03/2024

In this article we discuss the effects of coeliac disease on your weight, the links between coeliac disease and weight gain and how people with coeliac disease can manage their weight after being diagnosed.

What is coeliac disease?

Coeliac disease is an autoimmune disease that develops over time because of a sensitivity to gluten; a protein found in certain cereal grains including wheat, rye, and barley, and commonly used in food products such as cereal, bread, and pasta.

When a person with coeliac disease eats gluten, it causes the body’s immune system to attack its own tissues, causing damage to the gut lining and preventing the body from adequately absorbing nutrients from food.

People with coeliac disease can experience unpleasant symptoms when they eat gluten, such as bloating, flatulence, diarrhoea, nausea and vomiting.

If left untreated, it can lead to severe complications, which can negatively impact a person’s quality of life.

Coeliac disease affects around 1 in 100 people in the UK, but only 30% of these people are diagnosed, leading experts to believe that there are many more people suffering with it.

This is because milder cases can go undiagnosed or be misdiagnosed as irritable bowel syndrome (IBS).

Everything you need to know about coeliac disease

There is a link between coeliac disease and weight gain. However, this weight gain usually occurs once the person with coeliac disease is diagnosed and has begun to remove gluten from their diet.

When a person with coeliac disease eats gluten (prior to diagnosis and the adoption of a gluten-free diet), the immune system reacts, causing damage to the gut lining. This reduces the body’s ability to absorb vital nutrients which, in turn, can lead to weight loss.

Weight loss is a common symptom of coeliac disease along with other unpleasant symptoms including bloating, diarrhoea, nausea, vomiting and flatulence.

However, without the constraints of these symptoms, people with coeliac disease may begin to enjoy and indulge in food more freely, which can lead to weight gain.

Other factors that can contribute to weight gain in people with coeliac disease include:

Improved nutrient absorption

Once the lining of the gut begins to heal, more nutrients can be absorbed from food.

Over-indulgence in gluten-free substitutes

Many gluten-free alternatives of food staples such as breads, flour, pasta, and cereals, can have a higher calorie content than their gluten-containing counterparts.

One study found that gluten-free options contained higher quantities of fats, carbohydrates, salt, and sugar, while protein and fibre content was much lower.

Inflammation

There is evidence to suggest that inflammation can alter your metabolism.

Metabolism is the body’s way of processing food and turning it into energy. People with ‘high’ metabolisms burn calories more quickly – even when they are at rest – than someone with a slow metabolism.

For a person with coeliac disease, eating gluten causes inflammation of the gut lining. This can slow metabolism leading to weight gain and can also make it harder for the person to lose weight.  

How common is weight gain in people with coeliac disease?

It is common for people with coeliac disease to gain weight after they have been diagnosed.

Before diagnosis, weight loss is a common symptom due to the way in which coeliac disease causes damage to the gut lining, affecting the body’s ability to properly absorb nutrients from food.

If a person with coeliac disease adopts a gluten-free diet, their gut can begin to heal and absorb nutrients from food properly, which can contribute to weight gain.  However, there are other factors to consider.

For example, a person with coeliac disease may have been used to eating larger portions of food before cutting out gluten, to offset some of the symptoms associated with poor nutrient absorption (e.g. fatigue).

Gluten-free alternatives to food items like bread, cereal and pasta can contain higher quantities of carbohydrates, fats, salt, and sugars. This increases the risk of weight gain in people who continue to eat large portions after switching to a gluten-free diet.

Although not necessary for a healthy diet, gluten is a natural protein that is found in many processed food items, and even some medicines. Getting rid of gluten-containing foods can be very hard for someone with coeliac disease, especially if they are used to eating gluten-containing foods that are high in sugars and fats.

To compensate, they may eat more foods that do not contain gluten but are still high in sugar and fat, which can lead to weight gain.

What causes people with coeliac disease to gain weight?

Removing gluten from the diet is the only way to treat coeliac disease. When people with coeliac disease stop eating gluten, their gut lining begins to heal, and most see a vast improvement in their health.

One side-effect of becoming gluten-free that some people experience is weight gain.

Although weight gain might not affect everybody who becomes gluten-free – just like how not everyone who has undiagnosed coeliac disease will experience weight loss – it is common for weight gain to occur once gluten is removed from the diet.

There are many reasons why people may gain weight after removing gluten from their diet, including:

Improved nutrient absorption from foods

This occurs once the gut lining begins to heal, contributing to weight gain.

‘Leaky gut’ caused by inflammation of the gut lining

Coeliac disease is known as a chronic inflammatory condition because eating gluten causes an immune response in the form of inflammation. Leaky gut is a condition whereby damage to the intestinal walls allows bacteria and toxins to enter the bloodstream. This can contribute to weight gain and make it harder to lose weight.

Ability to enjoy food more freely

Once gluten is removed from the diet, and symptoms of coeliac disease are reduced, a person with the condition may begin to enjoy food more and might even eat more than usual, knowing that they will not experience the same unpleasant after-effects.

Gluten-free foods can be unhealthy foods

While not all processed foods are ‘unhealthy’, some foods, like cakes, sweets, crisps and sugary drinks are recognised as foods that should be limited (BNF, 2021).

Nowadays, people who have coeliac disease are far less restricted with what they can eat, because gluten-free alternatives to our favourite household meals and snacks are readily available, and many restaurants offer a choice of gluten-free meals.

Some studies have found that some gluten-free alternatives of food such as breads, cereals, pastas and some snacks contain more carbohydrates, fats, sugar and salt, whilst also being lower in nutrients like protein and fibre.

This means that indulging in foods that are high in sugar and fats, even if they are free from gluten, can lead to weight gain.

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How can people with coeliac disease manage their weight?

It can be hard for a person with coeliac disease to manage their weight because of the effect that gluten has on the body, coupled with the high calorie content of gluten-free food alternatives.

Some tips for managing your weight if you have coeliac disease include:

  • Getting into the habit of checking the nutritional values on gluten-free foods. This might help you to make healthier choices when shopping for gluten-free alternatives.
  • Consulting with a dietitian who specialises in the science of nutrition may assist you with managing your weight in the long term.
  • Where you can, try to cook from scratch using fresh ingredients. Cooking meals yourself means you have more control over how much fat, protein, carbohydrates, salt, and sugar is in your food. Try to keep ultra-processed foods like sweets, cakes, biscuits, crisps, and sugary drinks, to a minimum.
  • There are several websites and apps available that you can use to help track your eating habits and count calories. Most can also be used for free, without subscription.

If you have been diagnosed as having coeliac disease, it is advised that you speak to your GP for advice and guidance on managing the disease and making healthy food and lifestyle choices.

Coeliac UK also has a wealth of resources on its website on how to manage coeliac disease once diagnosed, including guidance on maintaining a gluten-free diet.

Can coeliac disease also cause weight loss?

Yes, coeliac disease can cause weight loss. In fact, weight loss is a common symptom of coeliac disease.  

When a person with coeliac disease consumes gluten, this triggers an immune response in the body, damaging the lining of the gut. This makes it harder for the body to absorb nutrients from food, causing weight loss.

The lining of the small intestine is made up of finger-like structures called villi, which have smaller structures called microvilli. Both villi and microvilli are richly supplied with blood vessels, and greatly increase the surface area of the intestines, enabling the body to absorb as many nutrients from food as possible.

If a person with coeliac disease eats gluten, the villi become inflamed and flattened. In more severe cases, they can be destroyed completely. This reduces the surface area of the intestines.

If the villi become damaged or destroyed, the intestines cannot absorb nutrients from food as well. This can cause health problems such as anaemia, osteoporosis, and weight loss.

It’s important to note that while some people do experience weight loss before being diagnosed with coeliac disease, not everybody will.

If you think you might have coeliac disease, you should speak with your GP who can refer you for tests.

A Genetic Coeliac Disease Test can also be useful and can help you rule out the possibility of coeliac disease or determine whether you could be at risk of developing coeliac disease in the future.

The results of an at-home test can also be shared with medical professionals and could help you gain a diagnosis more quickly.

Where can I get tested for coeliac disease?

Coeliac disease is a serious autoimmune condition that can cause lasting damage to the body if not diagnosed early.

This means that if you are experiencing symptoms that could indicate coeliac disease such as bloating, diarrhoea, nausea, vomiting and/or flatulence, it is important that you speak to your GP who will be able to advise on next steps for testing and diagnosis.

Diagnostic testing for coeliac disease usually includes blood testing for antibodies and, depending on the results of the blood test, a gut biopsy to assess any damage to the gut lining.

However, before undergoing any unnecessary invasive testing, an at-home genetic test for coeliac disease is useful for determining whether you are at risk of having or developing coeliac disease.  

The AlphaBiolabs Genetic Coeliac Disease Test can tell you whether you have the HLA-DQ2 or HLA-DQ8 genes that are linked to coeliac disease.

Our simple, at-home test is quick and completely pain free, with only two buccal (cheek) swabs required. Results are provided in just 4-5 working days.*

The results of the test can also be shared with your doctor, to facilitate a faster diagnosis.

A negative result for the HLA-DQ2/HLA-DQ8 genes means that you are unlikely to ever develop coeliac disease. This is because these genes are necessary for coeliac disease to develop.  

It’s also important to note that simply having these genes does not guarantee that you will develop coeliac disease or that you are currently suffering from it.

You can order your Genetic Coeliac Disease Test online now.

Alternatively, call our friendly, knowledgeable Customer Services team on 0333 600 1300 or email info@alphabiolabs.com for more information.

*From receipt of your samples at the laboratory.

Genetic Coeliac Testing

Order your genetic coeliac test from our award-winning laboratory.

Liz Wood, AlphaBiolabs

Liz Wood

Health Testing Specialist at at AlphaBiolabs

Liz joined AlphaBiolabs in 2021, where she holds the role of Health Testing Specialist.

As well as overseeing a range of health tests, she is also the lead on several validation projects for the company’s latest health test offerings.

During her time at AlphaBiolabs, Liz has played an active role in the validation of the company’s Genetic Lactose Intolerance Test and Genetic Coeliac Disease Test.

An advocate for preventative healthcare, Liz’s main scientific interests centre around human disease and reproductive health. Her qualifications include a BSc in Biology and an MSc in Biology of Health and Disease.

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