According to recent studies and reviews, a significant proportion of individuals with inflammatory bowel disease (IBD) in the European Union and the UK are considered overweight. A 2021 study published in the “Journal of Crohn’s and Colitis” analyzed data from over 22,000 IBD patients and found that around 30% of them had a body mass index (BMI) between 25 and 29.9, which is considered overweight. Similarly, a 2020 study published in the journal “Gut” analyzed data from over 38 million people registered with GPs in the UK and found that around 30% of individuals with Crohn’s disease and 25% of those with ulcerative colitis were overweight. Another study published in “Alimentary Pharmacology & Therapeutics” in 2018 suggested that up to 40% of individuals with IBD were overweight or obese (BMI over 25). These findings are concerning, as the prevalence of overweight and obesity in the general population is also increasing, which may partly explain the rising rates seen in the IBD population.
It is interesting why people with IBD may become overweight or obese despite the general belief that they are usually skinny. A few factors can contribute to this, such as reduced physical activity during flare-ups due to fatigue, pain, and discomfort. Additionally, some medications used to treat IBD, like corticosteroids, can increase appetite and calorie intake. IBD can also affect nutrient absorption, which can trigger cravings for certain foods and potentially lead to weight gain. Changes in the gut microbiome and other conditions like depression or anxiety can further impact lifestyle choices and contribute to weight gain.
Regardless of whether an individual has IBD or not, certain lifestyle factors apply to everyone, including dietary choices, stress, and lack of sleep. Poor dietary choices, such as consuming foods high in processed sugars and unhealthy fats, can lead to weight gain in individuals with or without IBD. Chronic stress, which individuals with IBD often experience, can trigger hormonal changes that promote fat storage and unhealthy eating habits. Also, poor sleep quality can disrupt hormones involved in appetite regulation and metabolism, contributing to weight gain.
Personally, my biggest struggle was becoming skinny during flare-ups and what mainly was worrying – muscle loss. Then, receiving high doses of corticosteroids was making me gain weight. But my gains were gaining fat tissue due to uncontrollable hunger, emotional eating, poor choices, and obviously, a lack of physical activity. So, from the health perspective, it is the worst scenario. Each flare-up left me with less muscle (a powerhouse of our metabolism) and colossal fat and water deposits. And I thought I was hitting the wall with all this until I discovered that exercise is a key—and more specific – muscle memory. The more I invested time in becoming fit when I had a spell of health, the quicker I returned to normal after the flare-ups due to the magic of muscle memory. My attitude and confidence were also different because I so strongly started to believe in this. This also contributed to better management of my weight.
I understand how frustrating it can be for people with Crohn’s or Colitis to gain weight on top of dealing with so much already. It can affect both our mental health and body image. Although it may seem unfair, the laws of thermodynamics don’t discriminate, and the same rules apply to everyone – eat less and move more. I would love to say there are some leeways for those of us going through so much in life. But unfortunately – no mercy.
But don’t worry; with some effort and dedication, it’s possible to manage weight and maintain a healthy lifestyle with IBD. Starting now will help build long-term adaptations that will make you stronger and better prepared for the next flare-up.
Looking for guidance and support on your weight loss journey?
