Weight Gain on the Gluten-Free Diet | BIDMC of Boston (2024)

Maintaining a Healthy Weight While Eating Gluten-Free

People with celiac disease may experience weight gain after starting a gluten-free diet; this initial weight gain indicates that their intestinal health is improving and they are more effectively absorbing nutrients. However, gaining too much weight can lead to multiple health problems. Read our tips and suggestions below to learn about maintaining a healthy weight while on the gluten-free diet.

I was diagnosed with celiac disease and started eating a gluten-free diet a few months ago. Now I'm gaining weight. What's going on?

Gaining weight after starting a gluten-free diet is common in people diagnosed with celiac disease.1,2 In fact, it is a sign that the intestinal lining is healing. However, if weight gain continues and leads to being overweight, other health concerns can arise, such as heart disease and high blood pressure. 3 Find answers to common questions about weight gain on the gluten-free diet below.

There are several factors that may lead to excess weight gain on the gluten-free diet:

  • Before being diagnosed with celiac disease, you may have become used to eating large portions without gaining weight because you were not fully digesting or absorbing the food.4
  • As the lining in your intestines begins to heal on a gluten-free diet, your ability to digest and absorb food recovers. You will absorb more of the nutrients from food, including more calories, leading to weight gain if you continue to eat the same portion size.
  • In an attempt to avoid gluten exposure or to make up for feeling deprived of other foods, you may find yourself eating more meat, cheese, desserts and other unhealthy foods that are high in fat and sugar. This can lead to weight gain.
  • Gluten-free processed foods often contain more calories, fat, sugar and carbohydrates, and less fiber than gluten-containing processed foods.5 Over-eating these particular foods can lead to unwanted weight gain.
  • New research is uncovering how the gut microbiome (bacteria that live in your colon) is involved in regulating diet and food choices.6 However, we still have a lot more to learn.

I'm glad I'm feeling better, but I didn't want to gain weight. How can I turn this around?

The first step is to connect with a professional who can help. Working with a registered dietitian nutritionist (RDN) has been shown to help patients adopt a healthier gluten-free diet and lose weight.7 If you are struggling with emotional issues related to celiac disease affecting your diet, ask for a referral to a clinician who specializes in this area.

One strategy that has proved to be successful for those wanting to lose weight is to track what they eat. There are many free online and mobile apps that can help; here are just a few suggestions. All of the websites listed below also have mobile apps available for download.

Compare your food log to the estimated calorie requirements for your age and activity level. If you are consuming too many calories, you're likely to gain weight.

I don't have time to count calories. Is there anything else I can do to improve my diet?

Consider the plate method, which is based on the USDA's MyPlate model; many registered dietitians recommend it as a sound method for estimating proper portion sizes. This method is simple and encourages more nutrient-dense foods, such as fruits and vegetables.

Picture a dinner plate that is divided into four sections:

  • 25% of the plate is for lean protein, including meat, poultry, seafood, beans, eggs, nuts and seeds. If you choose veggie burgers or other meat substitutes, make sure to read labels carefully as they may not be gluten-free.

  • 25% of the plate is for gluten-free grains, both refined and whole grains. However, by eating more whole grains, you're likely to feel more satisfied and get more important vitamins and minerals. Choose gluten-free whole grains such as brown rice, wild rice, millet, quinoa, buckwheat, teff, amaranth, and whole-grain corn. Remember, all grain products (except plain rice) should be labeled gluten-free.

  • 30% of the plate is for non-starchy vegetables. Whether they are fresh, frozen, or canned, all vegetables fit on the plate. Choose a variety of colors of vegetables for the most nutritional benefits. Budget-friendly canned vegetables should be rinsed to remove added salt, or purchase varieties labeled “no salt added.”

  • 20% of the plate is for fruits. Just like vegetables, fresh, frozen or canned all fit on the plate. Again, choose a variety of colors for the most nutritional benefits. If you choose canned fruits, consider buying them in juice or water to reduce added sugar.

  • Finish off your meal with a serving from the dairy group. This includes milk, cheese, and yogurt. If milk doesn’t agree with you, you can also select calcium-fortified non-dairy beverages, such as soy milk. Almond milk and rice milk are also good choices but are significantly lower in protein than cow or soy milk. Choose fat-free or low-fat dairy for lower calorie content.

I’ve heard that sugar causes weight gain. Is this true?

Sugar specifically doesn’t cause weight gain. However, foods containing sugar (especially added sugars, such as those found in sweetened beverages and foods) tend to contain more calories, which leads to weight gain. Here are some tips for reducing sugar"

  • Cut down on sugar-sweetened beverages, such as soda, sweet tea, and sports drinks. Choose water whenever you feel thirsty.
  • Watch for sneaky sugar where it isn’t needed. Foods such as spaghetti sauce, ketchup, yogurt, and cereal don’t need added sugar to be delicious.
  • Choose gluten-free energy bars and granola bars with lower sugar content. Some of these products have as much added sugar as candy bars.
  • Reduce sugar when you bake. You can safely omit one-third to one-half of the sugar in baked products without sacrificing taste. You can also substitute unsweetened applesauce in baking. Try vanilla or almond extract, or spices such as cinnamon, cardamom, and nutmeg to make foods sweeter without adding calories.
  • Top it off differently! If you always reach for syrup for gluten-free waffles or pancakes, try frozen fruit instead. You can also top gluten-free oatmeal with low-sugar Greek yogurt or fresh fruit.

Do I have to watch how much fat I eat?

Fat isn’t bad for you; it’s a necessary nutrient. However, high-fat foods tend to be high in calories and can lead to weight gain. Choose healthy fat whenever possible.

  • Saturated fats are solid at room temperatures, such as butter, lard, and some vegetable oils such as coconut or palm oil. When too many saturated fats are consumed, it can raise blood cholesterol and heart disease risk. Try to keep saturated fats to no more than 8-10% of your daily calories.
  • Unsaturated fats such as olive oil, canola oil, and grapeseed oil are liquid at room temperatures. These are heart-healthy choices.
  • Trans fats may naturally occur in some foods (in small amounts) such as lamb, beef, butter, and milk. Unhealthy added trans fats, which used to be added to foods such as crackers, cookies, and other snacks, were banned in the United States in 2018, so you won’t see these in foods anymore.8

What about exercise? Can that help me lose weight?

Physical activity also plays a role in weight loss, but to a lesser extent than your diet. However, daily physical activity has many other benefits, such as improved blood pressure, blood sugar, cholesterol, and better energy and mood.

  • If you are already active, great! Keep it up.
  • If you are just getting started, start slowly with walking, up to 30 minutes per day, five days a week.9
  • If you are looking to lose weight, try to increase your exercise to 60 minutes a day on most days.
  • Remember, it doesn’t have to be all at once — you can walk 30 minutes early in the day and then 30 minutes in the evening.
  • You can also work physical activity into your daily life, such as taking the stairs instead of the elevator, walking during commercial breaks while watching television, or parking farther from the store entrance.
  • Don’t forget about strength training. It’s not necessary to have an expensive gym membership to lift weights. Try some 5-pound free weights, or even lift cans of food.
  • If you are new to exercise and need fun and short workouts, YouTube is a great place to start. Channels such as FitnessBlender and Sworkit provide short workouts that can fit into your busy life.
  • Check with your doctor before beginning to exercise if you have certain medical conditions that may alter or limit your exercise program.

Take-Home Messages

  • Initial weight gain on the gluten-free diet typically indicates improving intestinal health, but too much weight can lead to other health risks. Many processed gluten-free foods are high in sugar, fat and calories. Once your small intestine has healed, you may not need to eat as much food as you once did before.
  • Gluten-free does not mean it is healthy. Using the general guidelines for a healthy diet will help promote healthy weight management. Read our Healthy Eating on the Gluten-Free Diet guidefor more information.
  • Certain medical problems, such as low thyroid hormone levels, can also cause weight gain.1 Be sure to check with your doctor if these simple dietary changes do not resolve the weight gain issue for you.
  • If it is difficult to manage your weight on the gluten-free diet, discuss it with your doctor and visit a registered dietitian for advice. There are practitioners available who are experts in intuitive eating and may help with your new diet approach.

References

  1. Kabbani TA, Goldberg A, Kelly CP, et al. Body mass index and the risk of obesity in coeliac disease treated with the gluten-free diet. Aliment Pharmacol Ther. 2012;35(6):723-729.
  2. Kabbani TA, Kelly CP, Betensky RA, et al. Patients with celiac disease have a lower prevalence of non-insulin-dependent diabetes mellitus and metabolic syndrome. Gastroenterology. 2013;144(5):912-917.e1.
  3. Welstead L. The gluten-free diet in the 3rd millennium: rules, risks and opportunities. Diseases. 2015;3(3):136-149.
  4. Theethira TG, Dennis M, Leffler DA. Nutritional consequences of celiac disease and the gluten-free diet. Expert Rev Gastroenterol Hepatol. 2014;8(2):123-129.
  5. Valletta E, Fornaro M, Cipolli M, Conte S, Bissolo F, Danchielli C. Celiac disease and obesity: need for nutritional follow-up after diagnosis. Eur J Clin Nutr. 2010;64(11):1371-1372.
  6. Rinninella, Cintoni, Raoul, et al. Food components and dietary habits: keys for a healthy gut microbiota composition. Nutrients. 2019;11(10):2393.
  7. Cheng J, Brar PS, Lee AR, Green PHR. Body mass index in celiac disease: beneficial effect of a gluten-free diet. J Clin Gastroenterol. 2010;44(4):267-271.
  8. Harvard T.H. Chan School of Public Health. Artificial trans fats banned in U.S. News. Published June 19, 2018. www.hsph.harvard.edu. Accessed March 3, 2022.
  9. U.S. Department of Health and Human Services. Current Physical Activity Guidelines. Health.gov. Published 2019. Accessed March 3, 2022.

Revision Date: March 3, 2022
Editors: Melinda Dennis, MS, RD, LDN and Amy Keller, MS, RD, LDN

Weight Gain on the Gluten-Free Diet | BIDMC of Boston (2024)
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