If I Have Crohn's, Why Am I So Overweight?

I have to comment that my Crohn's affects my small bowel and intestine and I have had troubles loosing weight. I keep gaining weight regardless of how healthy I eat, and I am quite active (depending on how I feel, and If my Crohn's decides to be a pain in butt)
So I really don't think that has anything to do with it.

I did run this by my GI fairly recently who told me that being over weight and having Crohn's depends mostly on where the Crohn's is, plus the body goes into hoarding mode as soon as the fasting is over...run my thyroid problem into the equation and lack of mobility and it does not take long to pile on those pounds...but I still cannot accept that I have gained so much though.

I have been put on the list for weight loss surgery, but because I had a small flare up the surgeon and the GI would not agree to out me on the list until remission...I am back on Asacol and went into remission fairly quickly...however they will not agree to do the full Gastric Bypass, but have agreed between them that I would benefit from the Sleeve Gastrectomy and that's fine by me...I am at last on the list but all those tests have held things up so it looks like I won't get my operation until August/September.

According to my GI, he said that my health would benefit by having the Sleeve and reducing weight because I won't go on to develop full diabetes. If I have to go on steroid's because of the Crohn's, at least my weight won't be an issue. My heart will be healthier and I'll be better able to cope with a full on flare up.

I definitely agree about the women's hormones playing a huge part because I had the worse flare up and was really ill when I got diagnosed with Colitis (now discovered it was Crohn's), hypothyroidism and peri-menopausal. All of that, I believe had a huge impact on the way my body is now.

If anyone is seeing their nutritionist in the near future, see what they have to say about it...

Wishing everybody well

Snow xx

I apologize in advance for going against the grain on parts of what most have said in this post, but i guess there always has to be a couple people who dont share the same views as the majority (alot of advancements in civilization occured this way :) ).

In my opinion, outside of drug related weight gain, which i completely agree occurs, the rest of the weight gain is mostly based on the same factors any non-Crohn's person has. There was an earlier post where a poster said that research had found that 6% of Crohn's patients were obese. While i think the poster was looking at this as a "thats a high percent" view, in fact, its a pretty good number when you compare with the current numbers in the U.S. that have 64% of americans being overweight, and 24% being obese. Those numbers make Crohn's patients actually look good.

THe same factors that cause the average person to be overweight or obese, i believe are the same factors that make up for, not all, but the majority of weight issues with Crohn's patients.

In my mind these factors are diet, lifestyle, and of course genetics. While some of these factors are influenced by Crohn's, they still are the underlying factors on weight gain.

Diet is affected by Crohns in two ways that i can see, first, i know fellow Crohns suffers, who despite their condition, still indulge in either too many calories, or calories from nutritionally useless foods (pop, chips/snack food, foods high in saturated fats), this in combination with the fact we cant eat a good portion of "good foods" like fruits, veggies, whole wheat, etc, which in fact have Vitamins and Minerals that actually help the body regulate metabolism, and in return body weight, causes a bad combination for gaining weight from bad nutrition.

Lifestyle is also a biggie for both reasons associated with and not associated with Crohn's. For reasons associated with Crohns, many people dont get the proper excercise just because of the condition of their Crohn's, for those of us that can get in the excercise, maintaining weight is pretty easy, but when you look at it from a view of "normal" people, if the  average person did nothing but sit around and get no excercise, they would gain just as much weight, if not more because they probably absorb calories better than us. On the side of self induced issues, once again, my two Crohns friends who are overweight have partially caused their own issues. They both have the attitude of "I am probably going to die younger than everyone else, and later in life not be able to enjoy myself, so i might as well have fun now" so they smoke, drink, dont get proper sleep, all of which are a bad combination for both weight gain, and of course the disease itself.

Last thing on the list is genetics, there are the small minority of people who are genetically disposed to be overweight no matter what they do, while this is a small number, it still is a factor. Most of use have the "middle" genetics which allow us to both gain weight easily but lose easily, in an ideal non-Crohns world.

While Crohns definitly plays a factor in all of this, the underlying causes of weight gain are the same for us as anyone else in my opinion, its just we have a lot more roadblocks to overcome to get there since Crohn's prevents us or slows us down from performing all the fundamental pieces of proper weight management.

I believe i am a good example on how different CD can effect someones weight. I have had CD for 4 1/2 years now and been on Prednisone twice, which i on both occasions lost weight, quite the opposite of most people. I then had a 2 1/2 year remission on 250mg/day Imuran. Over the course of those 2 1/2 years i worked out 4-5 times a week, and maintained a fairly strict diet that consisted of about 3500-4000 calories a day, which i never gained an ounce of fat on. I am very lucky in the sense my disease has never gotten too out of control, i have never been hospitalized due to CD complications, and so far my CD has been fairly easy and straight forward to control with Imuran alone. I just entered a flare a month ago, which was mainly stress and lack of sleep induced because of a new project at work, but i am trying to control it through diet and rest, and trying to avoid going on a round of Pred. If you are lucky enough to have CD under control, proper weight maintenance is achievable, like everything it just takes a little extra work, but if you dont have control, it is expected you are going to gain weight just from the above principals alone.

Naturally, I have kind of a stalky build. When I got sick in highschool however, my senior year I only weighed about 120 pounds. (I was a rail) After being treated and feeling healthy for a few years (and going off to college), I gained a ton of weight and actually weighed in around 235 almost a year ago... Now, through diet and exercise I have lost about 60 pounds and am down to 170.

I'll give you an idea of what I do/eat to at least spark some interest:
They say getting your heartrate up in the morning is the best thing for you. I however, am not a morning person; I just make sure that I run 3 miles a day at least 4 -5 times a week with light weight-training. Try walking/jogging a mile, then doing a set of situps or crunches, then jog another mile, repeat. This interval training they say burns 3x the amount of fat than running straight through. If you're just starting out, just keep your heart pumping for 30 minutes; that's all that matters!!!

As far as eating; I eat healthier, but eat less as well. I wake up and eat a plastic cup of Dole Grapefruit or yogurt. Then, what I attribute most of my success to, is lunch. I eat a bowl of Special K with berries and Skim Lactaid (CD doesn't allow me to have dairy!) for lunch almost every day. They say you will lose 2 pounds a week just by substituting that for a meal. Not only is it good for you; but it provides you with some good vitamins, a few servings of fruit; and my favorite, FIBER! :-p

Now granted; CD doesn't make you fat or skinny. It can wreak havoc on your body in many different ways. I was so skinny originally because every time I tried to eat food or even smelled food, I'd kill over in pain and wouldn't eat. I'd much rather be overweight than sick. It just so happens that right now diet and exercise seem to be doing the trick for me... Not only with losing weight, but feeling healthy. (Even though my stomach actually hurts a little bit as I type this lol)

What A Life - I am glad this works for you...but a cup of processed fruit in the morning and then some cereal for lunch...this is not healthy.  You are not intacking enough calories and that is why you are losing weight.  Eventually, this will catch up with your body. 

I have learned a lot about nutrition and know that breakfast is very important and gets your metabalisim going.  What are you eating for snacks and dinner?

Many of you have raised some really interesting points, but none of us are experts, even the experts can't agree. My GI might say one thing and your another thing, I personally do not believe that all nutritionists sing from the same hymn sheet either....There are some that say that stress does not cause Crohn's but will exacerbate it.


Daryl, you put your points across really well and would appear to be in tune with your own body, you have listened to your overweight Crohn's friends and you and your friends have come to the conclusion that overindulgence plays the major part in obese Crohn's patients. I agree with you in 94% of Crohn's patients, but that 6% will have underlying problems that predispose them to obesity anyway.

In my own case, I have genetics, hormones, age, that determined that I would become overweight if I did not reduce my calorie intake to ridiculous levels to lose weight, if you add a flare up that puts you on your back for the best part of 18 months not just because of the pain but the pain medication that knocks you out for most of the day, exercise would be impossible...I suggest that for most, it is the snowball effect.

Javalay, you agree that for women hormones might play a part, but do not agree that hormones play a huge part in weight gain more so in the Crohn's woman...the Crohn's woman is no different to the normal woman in terms of hormonal influence and the female sex hormones play a very huge part in our weight...But yes I agree that an under-active thyroid (the thyroid produces the hormone triiodothyronine and thyroxine) for example would cause the same weight gain in a man as it would in a woman with or without Crohn's.

My GI told me that whilst most Crohn's patients lose lots of weigh during a flare up, it is usually because of the site of their flare, usually in the small bowel...because Crohn's can turn up anywhere in the gastrointestinal tract, from mouth to anus they will not mess around with the area that would cause mal-absorption...and that is why I will not be getting a Gastric Bypass...The gastric Sleeve is safer as it just means reducing the size of the stomach, and no intestine is cut.

Bottom line (no pun intended) is that no, I don't believe that Crohn's causes obesity in the 6% of obese Crohn's patients, but it can be a consequence of some of the symptoms of Crohn's.

Snow xx