How to Keep a Healthy Weight With Crohn’s Disease

Crohn's disease can make it hard to keep your weight healthy and get the nutrients you need. But it's possible.

The inflammation linked to Crohn’s can give you nausea and diarrhea, as well as curb your appetite. As a result, you may eat less, making it harder to keep weight on.

Some Crohn's medicines may also affect your weight. Corticosteroids such as prednisone can cause temporary weight gain. If you have a weight change, talk with your doctor.

Keep Track of Your Weight

Are you at a healthy weight now? Your doctor or a registered dietitian can help you find out. They can also help you come up with a plan to get to and maintain a healthy weight. Because Crohn's disease affects people in different ways, you will need a plan that's just for you.

Exercise

People often exercise to try to lose weight, but it may also help stop weight loss. Exercise may boost your appetite. Being active also helps strengthen bones and muscles, both of which can be weakened by Crohn’s. Building muscle may help you gain weight.

Research suggests that low-intensity exercise, like walking, won’t make Crohn's symptoms worse. You may want to avoid certain exercises during a flare. Talk to your doctor about what type of fitness routine would work best for you.

Eating Tips

  • Eat small meals or snacks every few hours rather than three large meals a day.
  • Stay hydrated by drinking plenty of water and other fluids.
  • When you’re not having a flare, focus on eating a wide variety of healthy foods.
  • To be sure you get enough nutrients, ask your doctor about taking a multivitamin.
  • If you have little appetite or trouble eating solid foods, try drinking liquid nutritional supplements.
  • After a flare, slowly add back the foods you have avoided and boost your calories and protein to help make up for what you may have missed.

Should You Go Gluten-Free?

It’s a big topic these days. Gluten is a protein found in wheat, rye, and other grains. But it can show up in anything from pasta and crackers to beer, energy bars, and salad dressing. If you have celiac disease, an autoimmune condition, eating gluten causes a sort of allergic reaction in your gut. The most common symptoms are similar to those of Crohn’s disease:

  • Bloating
  • Diarrhea
  • Weight loss

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Doctors don’t think there’s a link between celiac disease and Crohn’s disease other than they’re both inherited immune system disorders that affect your gut. But you might be gluten-sensitive and not know it -- most people who have celiac disease in the United States are undiagnosed.

Also, one study showed that going gluten-free did improve symptoms for people with inflammatory bowel disease. So if your doctor says it’s OK, it should be safe to try. If it makes you feel better, stick with it. And talk to your doctor about whether you should be tested for celiac disease.

Your Best and Worst Foods

Everyone is different, so you are the best judge of what you can and can't eat. Some foods may trigger flares for you, and some may not. No foods are proven to cause or worsen Crohn's.

It may help to keep a diary of what you eat and how you react to it. Over time, the diary may allow you to pinpoint troublesome foods and drop them from your diet. A food diary will also help you and your dietitian check the quality of your diet.

Some foods you might want to steer clear of:

  • Fiber. It’s usually a good thing, but when you have Crohn’s, too much of it can lead to bloating and diarrhea.
  • High-fat foods. Butter, margarine, and cream can lead to gas and diarrhea.
  • Gluten. If you’re sensitive or have celiac disease, it can cause bloating and diarrhea.
  • FODMAPs. This stands for fermentable oligo-di-monosaccharides and polyols. They’re sugars found in carbs and sugar alcohols. They cause bloating, diarrhea, and cramps. They may play more of a role for people with irritable bowel syndrome than inflammatory bowel disease, though, and you should talk to your nutritionist before you drop then to make sure you don’t get undernourished. High-FODMAP foods include:
    • Fructose: A sugar found in fruits, honey, and high-fructose corn syrup
    • Lactose. This is a sugar found in milk and milk products. If your body can’t process it (this is called being lactose intolerant), it can give you cramps, belly pain, gas, diarrhea, and bloating.
    • Oligosaccharides: These are carbohydrates with a small number of simple sugars. They’re found in:
      • Onions
      • Garlic
      • Artichokes
      • Cereal grains like wheat and rye
      • Legumes
    • Polyols. Check the ingredients list of products like sugarless gum, ice cream, and candy for sorbitol, mannitol, and xylitol. These sugar alcohols can lead to bloating, gas, and diarrhea. They’re also in fruits like apples, pears, peaches, prunes, and their juices.

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What to Eat During a Crohn's Flare

As a general rule, the best foods to stick to during flares are bland, low-fiber, and low-fat. Some foods that may fit the bill are:

  • Bananas
  • White bread and white rice
  • Applesauce
  • Smooth peanut butter
  • Skinned potatoes
  • Steamed or broiled fish, such as salmon and halibut
  • Cheese, if you're not lactose intolerant
  • Refined pasta
  • Cooked vegetables
  • Cooked eggs or egg substitutes

Foods to Avoid During a Flare

Some foods can be hard to digest and may make the situation worse. You may want to avoid:

  • High-fiber foods
  • Fried foods
  • Full-fat dairy products, such as whole milk, half-and-half, and ice cream
  • Raw vegetables and fruits
  • Foods and drinks with caffeine, including chocolate and coffee
  • Beans
  • Cabbage
  • Carbonated beverages
  • Cakes, cookies, and other sweet foods

Getting Enough Nutrients

Crohn's makes it harder for your body to absorb vitamins and minerals such as:

You may get regular blood tests to check that you're getting the nutrients you need. If you're falling short, you and your doctor will come up with a plan. For instance, if you're low on vitamin B12, your doctor may recommend a supplement or B12 shots, depending on your condition.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on June 19, 2018

Sources

SOURCES:

American Society for Parenteral & Enteral Nutrition: "Nutrition and Crohn's Disease."

Eiden, K. Practical Gastroenterology, May 2003.

Crohn's and Colitis Foundation of America: "Diet and Nutrition," "Treating Children and Adolescents," "Living with Crohn's Disease," “Diet, Nutrition, and Inflammatory Bowel Disease.”

University of North Carolina School of Medicine: "Treatment of Crohn's Disease."

UCSF Medical Center: "Nutrition Tips for Inflammatory Bowel Disease."

Cleveland Clinic: "Diarrhea."

American Dietetic Association: "Crohn's Disease and Ulcerative Colitis Nutrition Therapy."

World Journal of Gastroenterology: “Inflammatory bowel disease and celiac disease: Overlaps and differences.”

Inflammatory Bowel Diseases: “Prevalence of a gluten-free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases.”

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