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Celiac Disease

The Skinny on: the Gluten-Free Diet and Your Weight

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For those with celiac disease who need to adapt to the gluten-free diet for their health, finding there’s weight gain involved along with the diagnosis is the ultimate kick in the pants.

Talk about an emotional rollercoaster: the celiac journey begins with years of feeling awful, with no answers in sight; then, the thrill of a diagnosis; next, the grieving period as celiacs say goodbye to favorite foods; then optimism, as you find a gluten-free diet you can live with; and finally, the frustration of gaining weight on the regimen that heals.

It’s been eight years of such ups and downs for Anna Baldassini. The 40-something mom and accountant, diagnosed with celiac disease in 2009, had been experiencing unusual symptoms since 2003, including iron deficiency and unexplained weight loss. Standing 5-foot-6, she’d long hovered between 160 and 170 pounds, but was down to 150 after her second child was born in 2004.

“People started saying I looked a little gaunt and skinny,” she recalls. “I hadn’t been that low since I was 16, so I was liking it.” Still, a nagging worry about her iron levels led her to an eventual celiac diagnosis.

Baldassini is an avid cook and baker who was used to spending hours in the kitchen making breads and cookies with her two kids. Determined not to feel deprived or go hungry, she immediately immersed herself in all things celiac – especially gluten-free baking. “I was in discovery mode,” she says. Within a year, she had gained 30 pounds. “I wasn’t paying attention. My weight started creeping up.”

The adjustment was hard, says Baldassini, who lives just north of Toronto with her husband and children. “I’m Italian, so I love to bake bread. Pizza and me are good pals. I felt like these things got pulled away from me.” That’s a common reaction among the newly diagnosed.

“Celiacs go through a series of emotions, including a mourning period of giving up their favorite foods,” says registered dietitian Beth Wall, a nutrition support specialist at the University of Chicago’s Celiac Disease Center. These feelings of sadness and anger are fueled and complicated by a subsequent weight gain. It just doesn’t feel fair.

So what is behind the extra pounds with a gluten-free diet? There are three main factors at play.

Healing Brings Calories: When a person with celiac disease eats foods containing gluten, the immune system responds by damaging or destroying the villi – the tiny, finger-like protrusions lining the small intestine that, among other things, help the body to absorb nutrients. But once on a gluten-free diet, the intestinal lining and the villi usually heal, and that’s when patients finally start absorbing protein, calories and fat, explains Alexandra Anca, a Toronto-based registered dietitian, celiac specialist and author of the recently published Complete Gluten-Free Diet & Nutrition Guide.

The result: those with celiac disease who eat the exact same amount of calories, protein and fat as they always did can suddenly begin to gain weight.

 Next: Overeating before diagnosis, with no weight gain

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