How to Gain Weight with Crohn's

Weight loss is common in Crohn’s patients. The long-term nature of the condition means that if you don’t pay attention to your weight, you can lose it to a dangerous degree.

Being severely undernourished not only makes it difficult for the body to fight Crohn’s, but also invites a whole range of other diseases. So here’s how you can approach weight loss in Crohn’s disease.

Get to the bottom of your weight loss 

Understanding why you’re losing weight is an essential part of stopping it. There are several reasons why Crohn’s patients lose weight. They include:

    • Reduced intake of food — while food hasn’t been shown to cause Crohn’s, many patients believe certain foods trigger their symptoms, which makes them reduce their intake
    • Reduced appetite — there are many reasons why this occurs in Crohn’s. One reason is a co-existing mental health condition like anxiety or depression, both of which are found more commonly in Crohn’s patients
    • Drugs — Crohn’s medications can make you both gain and lose weight. Drugs that cause weight loss include aminosalicylates and immunomodulators, which lead to diarrhea and vomiting with subsequent weight loss
    • Malabsorption — this is when the body doesn’t absorb nutrients and can happen if you have large areas of your bowels inflamed (or surgically removed). Certain nutrients (like vitamin B12) are absorbed only by a specific part of your bowel. This can lead to specific mineral and vitamin deficiencies in Crohn’s patients.
  • Loss of nutrients from vomiting, diarrhea, or bleeding — if you bleed chronically from your Crohn’s ulcers, you can get an iron-deficiency anemia

  • It’s a good idea to talk to your doctor about which of them might be causing your weight loss. Your doctor may prescribe you certain tests to figure out the cause, and once it's determined, can work to address it.

    While the exact cause for your weight loss is being worked up, here are some general steps you can take to improve your weight.


    Leverage exercise.

    When it comes to gaining weight, food is all we think about. While a healthy diet is certainly super-important in maintaining a healthy weight, people with Crohn’s disease can leverage exercise as well.

    Exercise will not only improve your appetite, but it will also counteract the harmful effects Crohn’s medications (like glucocorticoids) can have on your muscles and bones. 

    However, talk to your doctor before starting out exercise because some types are not recommended during a flare-up. Low-intensity exercises (like walking) are generally safe for Crohn’s patients.  


    Try a liquid diet.

    Crohn’s can affect your mouth or esophagus, making it difficult or painful to swallow solid foods. At other times, strictures can develop in your bowel. This can narrow your gut’s lumen and may cause solid foods to get obstructed.

    In these circumstances, juices and smoothies are an excellent way to add nutrients to your diet and weight onto your body.

    You can make a smoothie out of anything, which makes it a very feasible option. Here’s a pro tip: don’t drink a smoothie like water. If you do, you’ll waste its nutrients as your body won’t have the time to absorb it. Sip it slowly and maybe even swish it in your mouth before swallowing it!


    Maintain a food diary.

    A food diary is where you write down everything you eat (plus the serving size) and how you feel after eating it.

    One reason for weight loss in Crohn’s is that people start avoiding eating because certain foods trigger their symptoms. A food diary can help you identify those foods and then eliminate them from your diet for an overall better eating experience.

    Here is a list of foods you should generally avoid:

    • Processed foods — anything that comes in a box or bag should be avoided
    • High-fiber items
    • FODMAPs — this stands for fermentable oligo-di-monosaccharides and polyols. Foods rich in FODMAPs may cause diarrhea, nausea, and bloating. However, FODMAPs are mainly harmful in patients with irritable bowel syndrome, so before you drop them from your diet, consult a nutritionist or your doctor
    • Fatty foods

    To maintain a healthy weight, you should replace these foods with items low in fat and fiber. Examples include cooked vegetables, eggs, bananas, white bread, and skinned potatoes. The list is huge, so consulting a nutritionist is a good idea.


    Break up your meals. 

    Most of us eat 3 meals. As a Crohn’s patient, consider taking 5 or 6 smaller meals. That’s because people with Crohn’s feel full after eating even a small meal. So if you stay at 3 meals a day, the total amount of calories you take will be drastically reduced, leading to weight loss.

    So make up for your smaller meals by increasing their frequency. This may not cause you to gain weight, but it will certainly prevent you from losing it further.


    Eat nutrient-packed foods. 

    If your appetite is reduced, you can make up for the lost calories by eating foods with a high density of nutrients.

    Examples include:

    • Salmon
    • Tofu
    • Beans
    • Whole grains
    • Dairy products
    • Nuts
    • Fruits
    • Vegetables

    Processed foods are a big no, so even though they’re convenient, stay clear of them.

    A word of caution here. Many Crohn’s patients also suffer from lactose-intolerance, which makes it impossible for your body to absorb dairy products. After you consume a dairy product, you may experience nausea, diarrhea, and bloating. You’ll need to completely avoid dairy products if you have lactose-intolerance, and a food diary will help reach your diagnosis.


    Ask your doctor about vitamin and mineral supplementation. 

    A reduced appetite, malabsorption, inflammation, and medications can all quickly lead to vitamin and mineral deficiencies in Crohn’s disease, some of which are important for maintaining a healthy weight.

    For example, zinc is necessary for growth and development, and children with Crohn’s can become deficient in it leading to stunted growth.

    Another example is vitamin D, which helps maintain your bone mass and thus your overall weight.

    So one good way of maintaining a healthy weight is to supplement your diet with these vitamins and minerals. However, before you start any supplements, talk to your doctor!


    Medically Reviewed by Onikepe Adegbola, MD PhD

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