Maintaining a healthy body weight can be a challenge when you have Crohn’s disease. Although food doesn’t cause the inflammation and tissue damage in Crohn’s disease, some people may avoid food to prevent further discomfort.
If you have Crohn’s disease, you may not feel like eating when symptoms flare. Skipping meals may provide some relief, but the need for nourishment, especially enough calories, can’t be ignored. Malnutrition and unintentional weight loss are very common in many people with Crohn’s.
Treatment should also include regular monitoring of your body weight and other tests, as needed, to determine if you have any nutritional deficiencies.
Every person’s needs are different, which is why it’s important to work closely with your healthcare team to create an individualized dietary plan.
When you’re living with Crohn’s, weight loss is common. There are many factors that can cause weight loss. Finding out why you may have lost weight is key to finding a solution.
Once you determine why you’re losing weight, chances are good that your doctor or dietitian will be able to help you make changes to help keep your weight at a healthy level.
Read on to learn about factors that may be contributing to your weight loss.
Malabsorption
You may lose weight because your body doesn’t properly absorb nutrients like proteins, fats, sugars, vitamins, and minerals. This is called malabsorption.
With Crohn’s, malabsorption is usually due to inflammation in the small intestine, according to the Crohn’s and Colitis Foundation.
The degree of malabsorption depends on how many sections of your small intestine are inflamed or have been surgically removed and how large those sections are.
Lower food intake
Lower food intake is a leading cause of weight loss in people with Crohn’s. Loss of appetite, which can stem from Crohn’s symptoms such as stomach aches, bloating, and nausea, is often the reason for eating less.
These symptoms can make it difficult to eat enough food to get enough calories and proper nutrition, especially when you’re tempted to eat less — or not eat at all — to avoid discomfort and flare-ups.
Increased use of energy stores
Even with enough caloric intake, weight loss can happen because of the inflammatory process in Crohn’s disease.
Inflammation can lead to increased consumption of the body’s stored energy and a breakdown of body tissues, both of which can lead to weight loss.
Nutrient loss
Some Crohn’s symptoms, such as diarrhea, vomiting, and intestinal bleeding, can mean your body loses nutrients.
If these nutrients are not replenished by adequate food intake, nutrient loss can cause weight loss over time.
Medications
Side effects of some medications prescribed to treat Crohn’s include diarrhea and vomiting. If these side effects become frequent, they can lead to weight loss over time.
This is especially possible with medications in the aminosalicylates and immunomodulators categories.
Speak with your doctor if you find your medication is causing you side effects.
Diet
You may need extra calories in your diet to balance the body’s malabsorption or loss of nutrients.
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You may need to reduce or even eliminate specific components from your diet that may trigger flare-ups. These might include:
- gluten
- lactose
- fructose
- excess fiber
Be sure to consider any changes or restrictions you make in your diet with your dietitian to make sure you are still getting proper nutrition.
Reduced appetite has long been associated with Crohn’s disease. But once you and your healthcare team discover what’s causing your lack of appetite, there are strategies you can take to jumpstart it again.
Read on to see what may be causing your low appetite.
Flare-up symptoms
People with Crohn’s disease sometimes experience decreased appetite when flare-ups produce symptoms of nausea, bloating, abdominal pain, and diarrhea.
Symptoms like these can make you feel less like eating.
Overly restrictive diet
Some people with Crohn’s end up with too limited a diet by attempting to avoid foods that trigger symptoms.
Restricting a diet too much can make eating itself seem like a chore, and appetite may significantly decrease.
Hormone imbalance
Appetite loss may also stem from a hormone imbalance in people with Crohn’s.
This imbalance is thought to involve certain cells in the bowel. These cells act as sensors to relay nutrient information to the brain, which then affects appetite.
Though more information is needed to understand exactly how the process works, research suggests it may cause an increase in gut signals to the brain that decrease appetite.
Mental health conditions
Some mental health conditions, such as depression, anxiety, and stress, can also decrease appetite. These conditions are more common among those with Crohn’s and inflammatory bowel diseases (IBD) than in the general population.
Speak with a doctor if you think an emotional or mental health condition may be causing your loss of appetite.
Choosing the right foods to maintain a healthy weight can seem like walking a tightrope. Having Crohn’s often means you may not want to eat foods that trigger symptoms, but on the other hand, you don’t want to risk malnutrition.
Together with your healthcare team, you can develop a plan for you to achieve and maintain a healthy weight. Strategies vary, and there are many options to try.
Keep a food journal
The first suggestion our doctor will likely make is to keep a food journal. This is where you record what you eat and any symptoms you experience. It lets you and your dietitian see over time what works and what doesn’t.
Your dietitian can help you use your journal to develop an optimal diet that may relieve symptoms, help you maintain a healthy body weight, and help keep the disease in remission for longer periods of time.
Consider the variables
There’s no one-size-fits-all diet for Crohn’s. You’ll want to consider many variables when developing a diet plan.
For example, you’ll want to take into consideration your current symptoms and whether your disease is in a flare-up or is in remission.
The location of your Crohn’s, whether or not you have strictures, and any prior surgeries are all important, too.
You may also want to be tested for nutritional deficiencies and take steps to remedy these if you have any.
Develop your optimal diet plan
It’s important to talk with your doctor if you’re concerned about your weight or if you feel like your diet is too limited. They can recommend a nutritionist who will help you create a personalized diet plan.
Learn more about eating with Crohn’s.
Consider enteral nutrition therapy
One approach a healthcare professional may recommend for treating Crohn’s disease is enteral nutrition.
This involves introducing a liquid nutrient formula directly into the stomach or intestines using a tube that’s threaded through a nostril.
There are other routes of ingestion, including a surgically placed gastrostomy tube that enters directly into the stomach or a jejunostomy tube that enters directly into the stomach and then into the intestines.
Explore medications
Doctors have numerous approaches to treating Crohn’s disease that may help you get to and remain at a healthy weight.
Powerful drugs to decrease inflammation may allow the disease to go into remission for some people. Examples include aminosalicylates and corticosteroids.
Others may benefit from drugs such as immunomodulators, antibiotics, or the newest class of drugs called biologic therapies.
Maintaining a healthy weight with Crohn’s can be challenging. Any sudden, significant, or sustained unexplained weight loss is a signal to contact a healthcare professional.
Medical professionals and dietitians are your allies in developing treatment and dietary plans to help you achieve and maintain a healthy weight. There are a wide variety of treatments and eating plans to try.
You can also eat different foods at different times.
During a flare-up, you might not be able to eat everything you usually might. But there may be substitute foods you can try, such as nutritional drinks. Check with a healthcare professional about your options.