For some people with Crohn’s disease, the side effects of medication or symptoms of inflammatory bowel disease (IBD), such as nausea and abdominal pain, can trigger a loss of appetite; others lose weight because they avoid certain foods that can cause gastrointestinal distress. People with Crohn’s disease can also have trouble digesting food and absorbing its nutrients. This could lead to malabsorption, another possible culprit of weight loss, says Shawn Khodadadian, MD, a gastroenterologist, the director of clinical nutrition at Lenox Hill Hospital, and a clinical instructor of medicine at NYU Langone Medical Center in New York City. For example, if someone is experiencing inflammation in the small intestine, their body can also have trouble digesting food and absorbing nutrients, according to the Crohn’s and Colitis Foundation. Inflammation in the large intestine can trigger problems absorbing water and electrolytes. No matter the cause, always tell your doctor about unintentional weight loss. That way, you can identify your weight loss culprit and address it. 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 even cause death.
Get Back to a Healthy Weight With Crohn’s Disease
It’s important to work closely with your doctor to return to a healthy body weight. He or she should routinely monitor your Crohn’s disease and, if need be, prescribe a different medication. In addition, treating Crohn’s disease — reducing disease activity and calming inflammation — 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 to your diet. “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 make sure you aren’t missing out on any important nutrients, according to the Crohn’s and Colitis Foundation. Don’t expect immediate results. You should also take it slow as you attempt to return to a healthy body weight, says Karen Langston, a nutritionist specializing 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 and 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 include well-cooked asparagus and potatoes; good fruits to try include applesauce and melons. The organization recommends sticking to soft, fleshy fruits and avoiding the skins and seeds. People with Crohn’s may also need to up their intake of protein during a flare or when recovering from a bout of inflammation, according to the Crohn’s and Colitis Foundation. They suggest eating animal proteins such as fish, beef, pork, and eggs. Fish, such as tuna, are also a 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 and 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 emotions often associated with Crohn’s disease, he says.
