Worried About Weight Loss if You Have Crohn’s Disease?

If you have Crohn’s disease, you might also be dealing with unwanted weight loss. It’s a common symptom that can lead to other health complications, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

For some people with Crohn’s disease, the side effects of medication or symptoms of the inflammatory bowel disease (IBD), such as nausea and abdominal pain, can trigger a loss of appetite; others can lose weight if they avoid certain foods that can cause gastrointestinal distress.

People with Crohn’s disease can also have trouble digesting food and absorbing its nutrients, especially if they are experiencing inflammation in the small intestine, according to the Crohn’s & Colitis Foundation. Inflammation in the large intestine can trigger problems absorbing water and electrolytes.

This can lead to malabsorption, another possible culprit of weight loss, says Shawn Khodadadian, MD, a gastroenterologist at Manhattan Gastroenterology in New York and a board-certified physician nutrition specialist.

No matter the cause, it’s always important to tell the doctor about unintentional weight loss, so they can identify the culprit and address it.

Why Weight Loss With Crohn’s Disease Is a Concern

If you have Crohn’s disease and are losing weight rapidly, your body is at risk of not getting the nutrition it needs to function properly, Dr. Khodadadian says. Malnutrition affects 20 to 85 percent of people with IBD, according to a study published in 2020 in the journal Nutrients. It’s important to eat enough calories and nutrients, such as protein, to maintain a healthy weight and heal during times of stress, according to the Crohn’s & Colitis Foundation. If you’ve lost weight, the organization suggests adding 250 to 500 calories a day to your diet and talking to your doctor.

The amount of weight lost, the time frame involved, and the reason behind the loss will determine the level of concern, says Khodadadian. Some complications of malnutrition, he says, include decreased bone health (and increased risk of fractures), a weakened immune system, poor wound healing, and higher rates of infection. When severe, weight loss can cause hospitalization or even death.

Get Back to a Healthy Weight With Crohn’s Disease

To return to a healthy body weight, it’s important to work closely with your doctor, who should routinely monitor your Crohn’s disease and prescribe a different medication if your current one isn’t working. Importantly, reducing disease activity and calming inflammation through treatment can help your body recover and put you on a path to regaining weight, Khodadadian says.

Here are some strategies for maintaining a healthy weight with Crohn’s disease.

Track your meals and snacks. Keeping a daily food diary, with calorie counts and weight monitoring, can help determine if your weight loss is linked to changes in your diet. It’s especially important during a flare, so you can make sure you’re eating enough. “People with Crohn’s disease may have flares with periods of abdominal pain, diarrhea, and bleeding, and it’s important to remember that adequate calories and nutritional intake are even more essential when the inflammation is worse,” Khodadadian says. Try to eat small, frequent meals and increase your fluid intake.

Identify problem foods. You may find that certain foods add to your discomfort. If a particular food causes digestive problems, you can try to avoid it or minimize it in your diet. But this should always be done with the help of your doctor and a dietitian, to ensure you aren’t missing out on any important nutrients, according to the Crohn’s & Colitis Foundation.

Don’t expect immediate results. You should take it slow as you attempt to return to a healthy body weight, says Karen Langston, a nutritionist who specializes in digestive health, because Crohn’s disease already puts a lot of stress on your body. “Although you’re taking in nutrients, the weight may not come back on right away, because there’s repair work happening,” she says. “At first, the body is going to build itself back up — its muscles, hormones, and cells. Then the weight will start to return gradually.”

Choose the right foods. The Crohn’s & Colitis Foundation tells people with IBD symptoms to eat smaller, more frequent meals and cut back on greasy or fried foods. Easier-to-digest vegetables and fruits to try include well-cooked asparagus, potatoes, applesauce, and melons. The organization recommends sticking to soft, fleshy fruits and avoiding the skins and seeds.

You may also need to up your intake of protein during a flare or when recovering from a bout of inflammation, according to the Crohn’s & Colitis Foundation. They suggest eating animal proteins, such as beef, pork, eggs, and fish, such as tuna, which is a good source of healthy omega-3 fatty acids.

Managing the Emotional Toll of Crohn’s Disease Weight Loss

Although its primary effects are physical, Crohn’s can carry emotional baggage, too. Many people don’t understand the disease and make comments that are hurtful or frustrating, says Frank J. Sileo, PhD, a psychologist in Ridgewood, New Jersey. Dr. Sileo, who has Crohn’s disease himself, has heard statements ranging from “You’re so thin. You need to put a little meat on your bones” to “I wish I had Crohn’s disease, so I could lose weight.”

“My approach to these kinds of comments is to educate and use humor,” Sileo says. “I might say, ‘This darn Crohn’s disease keeps getting in the way’ or ‘You can have the diarrhea, joint pain, nausea, fever, and chills with that weight loss, too.’” And if anyone tries to attribute your weight loss to an eating disorder, he suggests explaining that Crohn’s disease isn’t an eating disorder or due to stress, but rather a form of IBD that requires medical attention.

It also might help to talk about your feelings. Sileo recommends contacting the Crohn’s & Colitis Foundation to find a support group in your area. A mental health professional who specializes in coping with chronic illness can also be helpful as you navigate the emotions often associated with Crohn’s disease, he says.