Healthy Weight

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 at the root of Crohn’s disease, people associate eating with flare-ups, and often avoid food to prevent further discomfort. Skipping meals may provide some relief, but the need for nourishment, especially adequate calories, can’t be ignored. Malnutrition and unexplained weight loss are very common in many Crohn’s patients. For these and other reasons, you should always work with a dietician to create a diet plan that works for you. Treatment should also include regular monitoring of body weight and other tests, as needed, to determine if you’re experiencing any nutritional deficiencies.

Even when your Crohn’s is in remission, you may have a low body weight because your body doesn’t properly absorb nutrients. You may require extra calories in your diet to counteract the body’s inefficient absorption of calories from food. You also may require a diet that’s free of specific components, for instance:

  • gluten
  • lactose
  • fructose
  • excess fiber

Every person’s needs are different, which is why it’s important to work closely with healthcare professionals to devise an individualized dietary plan.

General Guidelines for Weight Maintenance

The following guidelines, suggested by the Crohn’s and Colitis Foundation of America, may alleviate symptoms, help you maintain a healthy body weight, and help prolong disease remission.

  • Drink plenty of water throughout the day (in relatively small portions).
  • Eat small portions regularly throughout the day.
  • Minimize or eliminate foods that are high in fiber, including beans, nuts, seeds, raw vegetables, and popcorn.
  • Avoid fatty foods, including fried foods, and heavy cream or butter-laden sauces.
  • Lactose-intolerant people should avoid dairy or choose products which have relatively little lactose, such as hard cheeses.
  • Take supplements as directed to store up key nutrients, such as calcium, vitamin D, vitamin B-12, and folic acid.
  • If you know from experience that certain foods are likely to cause gas, put them on your “Foods to Avoid” list. Likely culprits include spicy foods, cabbage, broccoli, cauliflower, beans, and fruit juices. Citrus fruits may be especially problematic.

The Other End of the Spectrum

Low body weight is a common feature of Crohn’s disease and people with the condition often struggle to maintain a healthy body weight. However, there are also many people with Crohn’s disease who are overweight.

Being obese puts Crohn’s patients at increased risk for complications if they should need to undergo surgery to correct intestinal problems. A study on the wound-healing process published in the Journal of Dental Research showed that surgeries on obese patients often take longer to heal and are more likely to heal poorly, compared to individuals at a healthy weight.

Enteral Nutrition Therapy

Doctors have numerous weapons in their arsenal to fight Crohn’s disease. Powerful drugs to decrease inflammation may allow some people to go into remission. Examples include aminosalicylates and corticosteroids. Others may benefit from drugs such as immunomodulators, antibiotics, or the newest class of drugs called biologic therapies.

Another approach is enteral nutrition. Enteral nutrition involves introducing a liquid nutrient formula directly into the stomach or intestines using a tube that is threaded through a nostril. Some studies have shown that people respond as well to enteral nutrition therapy as they do to drug therapy with corticosteroids. This is especially true among children with Crohn’s.

Talk to your doctor if you’re concerned about your weight, or if you feel like your diet is too limited. They can recommend a nutritionist that will help you create a personalized diet plan.

You asked, we answered

  • How is maintaining a healthy weight different in children with Crohn’s?
  • Growth and development is extremely important in all children, and it can be specifically challenging when that child has Crohn’s disease. Malnutrition in children can lead to long-term issues including short stature, delay in puberty, and bone disease. All children with Crohn’s disease should have regular measurements of weight, height, BMI, and growth velocity by their pediatrician. Many children are picky eaters even without the symptoms of a chronic disease, so nutritional counseling and incentivizing should be a part of every child’s care plan. Supplemental nutrition by a nasogastric tube may be necessary for children to reach their growth goals. 

    - Healthline Medical Team