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Crohn’s disease is a type of inflammatory bowel disease (IBD) that comes with symptoms including abdominal pain, diarrhea, difficulty eating, and fatigue.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c737a3b-a8e3-4181-ba87-e9db84b3c093 Because of these common symptoms, people often associate Crohn’s disease with problems like unintentional weight loss or a trouble staying at a healthy weight.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c4b874f6-146a-48db-8aed-7b5776afdc55 But for some people living with this condition, unintentional weight gain can also be a part of the picture, whether it’s due to medication side effects or changes in activity levels or diet.e60dc2a1-f33c-4a05-9b50-8e3e8e597629ef785b9b-8b45-41ec-bedb-77f7ee0fa738 If you have Crohn’s disease, it’s important to work closely with your healthcare team to understand the connection between your condition and weight fluctuations.
Can Crohn’s Disease Lead to Weight Gain? Can Crohn’s Cause Weight Gain? Yes, Crohn’s disease can sometimes lead to weight gain. But that link isn’t as widely discussed as the condition’s connection with weight loss, according to Brigid Boland, MD , a gastroenterologist, assistant professor of medicine at the University of California San Diego, and a spokesperson for the American Gastroenterological Association. “From what we currently know, Crohn’s disease itself does not cause weight gain; however, there are likely different indirect ways in which weight gain could occur,” Dr. Boland says. The most common factors tied to weight gain in people with Crohn’s disease include: Medications and Their Side Effects Corticosteroids are often prescribed as a short-term solution to manage inflammation during a Crohn’s flare-up. They’re also a well-known cause of weight gain, says Alan Moss, MD , the chief scientific officer at the Crohn’s & Colitis Foundation and a professor of gastroenterology at Boston University in Massachusetts. “Steroids … can cause weight gain, and that’s typical visceral weight gain around the [abs] with changes in fat distribution, and also around the face,” Dr. Moss says. He notes that long-term use can also affect blood sugar and bone health. That’s why gastroenterologists typically aim to keep people with Crohn’s on steroids for no longer than about four weeks to manage a flare. Boland says that long-term steroid use can decrease metabolism, increase appetite, and cause fluid retention — all of which can also lead to weight gain. Moss says other, newer medications, such as biologics, don’t cause weight gain. People who do gain weight after starting biologics are typically recovering lost weight due to prior malnutrition or active disease. Diet Changes and Food Aversions Being unable to stick to a balanced diet is another major hurdle that can trigger weight gain in people with Crohn’s, Moss says. During a flare, it’s easy to shift toward eating foods that are easier to tolerate but more likely to cause weight gain, such as ultra-processed foods and refined carbohydrates . These habits can stick, even after you achieve remission. Some people tend to avoid eating healthy foods that cause symptoms during a flare, such as high-fiber foods and low-fat dairy. During remission, they can work these foods back into their diets, but they often don’t because they’re fearful of another flare-up. “No one ever tells them to reassess what [they’re] eating and get back to a more balanced diet,” Moss says. Fatigue and Inactivity When you’re dealing with Crohn’s symptoms, you may not have energy for a workout. But inactivity plus a change in diet can lead to gradual weight gain. “If the combination of feeling unwell, having low energy, and then eating highly processed foods [comes together], it’s a bad mix that will lead to excess weight gain,” Moss says. Stress and Emotional Eating According to research, people with IBD are 3 to 5 times more likely to develop disorders of anxiety or depression compared with people who don’t have the illness.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6d3d66a-ac9d-43fe-81d1-ed08b7f0fcc0 The stress of living with the illness can sometimes lead to changes in eating patterns, including overeating or what seems like emotional eating . According to one research review, this may be due to the activity of ghrelin, a hormone that increases appetite. Ghrelin, which also has anti-inflammatory properties, is thought to be particularly active during stressful periods. This may be part of an effort to protect against the damage of ongoing stress and to promote a return to your body’s normal state.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eadb719e-cc73-4fd9-8101-6c29666d8930 In other cases, some people might overeat once a flare-up has ended and it feels safe to eat again, says Chelsea Cross, RD , who’s also a personal trainer in Kitchener, Ontario, Canada. Cross has Crohn’s disease and works with clients who have IBD. “Once clients start to heal, [and] medications make them feel better, sometimes what happens is overindulgence in hyper-caloric foods, as many feel super restricted when they’re ill,” she says. Returned Appetite in Remission After successful treatment with medication or surgery that leads to remission, appetite may return quickly — and weight can rebound faster than expected. Try not to be alarmed when this happens, Cross says. Research suggests that 20 to 40 percent of people with Crohn’s disease lose weight during flares that don’t require a hospital stay.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a7e57f8-e63a-454e-99bc-81b39493de40 After you and your healthcare team settle on a treatment plan that works, you may see weight gain — an indication that you’re on the right track. “Weight gain can be positive … medication is reducing inflammation, allowing for greater [nutrient] absorption, and so the person is getting healthier,” Cross says.
4 Ways to Manage Crohn’s–Related Weight Gain How to Manage Weight Gain If weight gain becomes a concern for you, talk with your gastroenterologist and a registered dietitian. It’s important to deal with weight gain safely while also managing your illness. Some tips that can help include: 1. Monitor Medications and Side Effects Work with your gastroenterologist to discuss possible alternatives or adjustments if steroids are causing weight gain, Moss says. You have a variety of options to discuss, including: Tapering off of steroids Switching to newer medications that treat inflammation and obesity Finding out if weight-loss surgery (also called bariatric surgery) might be right for you Moss points to glucagon-like peptide-1 (GLP-1) analogs as one medication option to both treat Crohn’s and help with weight loss. These medications were first developed to treat type 2 diabetes, but they’ve also shown promise at helping people with IBD and obesity tackle both issues, according to research.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296dc6f3a0-d44f-4547-8ac4-a9b820b8e92d 2. Follow a Balanced, Crohn’s-Friendly Diet Creating a Crohn’s-friendly, balanced eating plan that works for you — during times of flares and in remission — is crucial to managing weight, Cross says. You may grapple with food aversions, food intolerances, and trouble with adding variety back into your diet that make it hard, however. This is why working with a registered dietitian is key. “As RDs, our job is to be able to support [people] with eating in a way that minimizes food-related symptoms while providing the most nutrients that we can,” she says. 3. Stay Active When Possible Try to work exercise into your daily routine, including gentle movements like walking, stretching, and yoga, Cross says. “[These exercises] not only help with stress management, but [they also] can help with digestion, regulate hunger signals, and give a boost of energy,” she says. ”They’re accessible, as they can be done anywhere at any pace.” You can also try mindfulness meditation sessions, therapy, or support groups if you feel your stress levels rising, Moss says. 4. Track Weight Changes Over Time Think about keeping a food and symptom journal (or using an app ). That can make it easier to notice patterns between dietary choices, your symptoms, and any weight fluctuations. For example, you may catch yourself eating too many processed foods and shift your focus to eating more whole foods, including fruits, vegetables, and lean proteins, Moss says. Bring up any health issues to your doctor. Other conditions, such as heart disease and type 2 diabetes, may develop in people with Crohn’s, especially as you age, Moss says. “Patients who have chronic inflammation do have some higher risk of cardiovascular disease. Obesity, on top of that, can give you an additive risk,” he says.
The Takeaway Crohn’s disease is usually tied to weight loss, difficulty eating, and diarrhea. But for some people with the condition, weight gain can also occur for a variety of reasons. Medications, especially steroids, and their side effects play a key role in weight gain. Some other risk factors are reduced physical activity, changes in diet, and stress levels. Managing weight gain safely requires a personalized approach, ideally with guidance from a gastroenterologist and a registered dietitian.
Resources We Trust Cleveland Clinic: Crohn’s DiseaseMayo Clinic: Crohn’s DiseaseCrohn’s & Colitis Foundation: Overview of Crohn’s DiseaseYale Medicine: Crohn’s DiseaseMedlinePlus: Crohn’s Disease
Can Crohn’s Disease Lead to Weight Gain? Can Crohn’s Cause Weight Gain? Yes, Crohn’s disease can sometimes lead to weight gain. But that link isn’t as widely discussed as the condition’s connection with weight loss, according to Brigid Boland, MD , a gastroenterologist, assistant professor of medicine at the University of California San Diego, and a spokesperson for the American Gastroenterological Association. “From what we currently know, Crohn’s disease itself does not cause weight gain; however, there are likely different indirect ways in which weight gain could occur,” Dr. Boland says. The most common factors tied to weight gain in people with Crohn’s disease include: Medications and Their Side Effects Corticosteroids are often prescribed as a short-term solution to manage inflammation during a Crohn’s flare-up. They’re also a well-known cause of weight gain, says Alan Moss, MD , the chief scientific officer at the Crohn’s & Colitis Foundation and a professor of gastroenterology at Boston University in Massachusetts. “Steroids … can cause weight gain, and that’s typical visceral weight gain around the [abs] with changes in fat distribution, and also around the face,” Dr. Moss says. He notes that long-term use can also affect blood sugar and bone health. That’s why gastroenterologists typically aim to keep people with Crohn’s on steroids for no longer than about four weeks to manage a flare. Boland says that long-term steroid use can decrease metabolism, increase appetite, and cause fluid retention — all of which can also lead to weight gain. Moss says other, newer medications, such as biologics, don’t cause weight gain. People who do gain weight after starting biologics are typically recovering lost weight due to prior malnutrition or active disease. Diet Changes and Food Aversions Being unable to stick to a balanced diet is another major hurdle that can trigger weight gain in people with Crohn’s, Moss says. During a flare, it’s easy to shift toward eating foods that are easier to tolerate but more likely to cause weight gain, such as ultra-processed foods and refined carbohydrates . These habits can stick, even after you achieve remission. Some people tend to avoid eating healthy foods that cause symptoms during a flare, such as high-fiber foods and low-fat dairy. During remission, they can work these foods back into their diets, but they often don’t because they’re fearful of another flare-up. “No one ever tells them to reassess what [they’re] eating and get back to a more balanced diet,” Moss says. Fatigue and Inactivity When you’re dealing with Crohn’s symptoms, you may not have energy for a workout. But inactivity plus a change in diet can lead to gradual weight gain. “If the combination of feeling unwell, having low energy, and then eating highly processed foods [comes together], it’s a bad mix that will lead to excess weight gain,” Moss says. Stress and Emotional Eating According to research, people with IBD are 3 to 5 times more likely to develop disorders of anxiety or depression compared with people who don’t have the illness.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6d3d66a-ac9d-43fe-81d1-ed08b7f0fcc0 The stress of living with the illness can sometimes lead to changes in eating patterns, including overeating or what seems like emotional eating . According to one research review, this may be due to the activity of ghrelin, a hormone that increases appetite. Ghrelin, which also has anti-inflammatory properties, is thought to be particularly active during stressful periods. This may be part of an effort to protect against the damage of ongoing stress and to promote a return to your body’s normal state.e60dc2a1-f33c-4a05-9b50-8e3e8e597629eadb719e-cc73-4fd9-8101-6c29666d8930 In other cases, some people might overeat once a flare-up has ended and it feels safe to eat again, says Chelsea Cross, RD , who’s also a personal trainer in Kitchener, Ontario, Canada. Cross has Crohn’s disease and works with clients who have IBD. “Once clients start to heal, [and] medications make them feel better, sometimes what happens is overindulgence in hyper-caloric foods, as many feel super restricted when they’re ill,” she says. Returned Appetite in Remission After successful treatment with medication or surgery that leads to remission, appetite may return quickly — and weight can rebound faster than expected. Try not to be alarmed when this happens, Cross says. Research suggests that 20 to 40 percent of people with Crohn’s disease lose weight during flares that don’t require a hospital stay.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298a7e57f8-e63a-454e-99bc-81b39493de40 After you and your healthcare team settle on a treatment plan that works, you may see weight gain — an indication that you’re on the right track. “Weight gain can be positive … medication is reducing inflammation, allowing for greater [nutrient] absorption, and so the person is getting healthier,” Cross says.
4 Ways to Manage Crohn’s–Related Weight Gain How to Manage Weight Gain If weight gain becomes a concern for you, talk with your gastroenterologist and a registered dietitian. It’s important to deal with weight gain safely while also managing your illness. Some tips that can help include: 1. Monitor Medications and Side Effects Work with your gastroenterologist to discuss possible alternatives or adjustments if steroids are causing weight gain, Moss says. You have a variety of options to discuss, including: Tapering off of steroids Switching to newer medications that treat inflammation and obesity Finding out if weight-loss surgery (also called bariatric surgery) might be right for you Moss points to glucagon-like peptide-1 (GLP-1) analogs as one medication option to both treat Crohn’s and help with weight loss. These medications were first developed to treat type 2 diabetes, but they’ve also shown promise at helping people with IBD and obesity tackle both issues, according to research.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296dc6f3a0-d44f-4547-8ac4-a9b820b8e92d 2. Follow a Balanced, Crohn’s-Friendly Diet Creating a Crohn’s-friendly, balanced eating plan that works for you — during times of flares and in remission — is crucial to managing weight, Cross says. You may grapple with food aversions, food intolerances, and trouble with adding variety back into your diet that make it hard, however. This is why working with a registered dietitian is key. “As RDs, our job is to be able to support [people] with eating in a way that minimizes food-related symptoms while providing the most nutrients that we can,” she says. 3. Stay Active When Possible Try to work exercise into your daily routine, including gentle movements like walking, stretching, and yoga, Cross says. “[These exercises] not only help with stress management, but [they also] can help with digestion, regulate hunger signals, and give a boost of energy,” she says. ”They’re accessible, as they can be done anywhere at any pace.” You can also try mindfulness meditation sessions, therapy, or support groups if you feel your stress levels rising, Moss says. 4. Track Weight Changes Over Time Think about keeping a food and symptom journal (or using an app ). That can make it easier to notice patterns between dietary choices, your symptoms, and any weight fluctuations. For example, you may catch yourself eating too many processed foods and shift your focus to eating more whole foods, including fruits, vegetables, and lean proteins, Moss says. Bring up any health issues to your doctor. Other conditions, such as heart disease and type 2 diabetes, may develop in people with Crohn’s, especially as you age, Moss says. “Patients who have chronic inflammation do have some higher risk of cardiovascular disease. Obesity, on top of that, can give you an additive risk,” he says.
The Takeaway Crohn’s disease is usually tied to weight loss, difficulty eating, and diarrhea. But for some people with the condition, weight gain can also occur for a variety of reasons. Medications, especially steroids, and their side effects play a key role in weight gain. Some other risk factors are reduced physical activity, changes in diet, and stress levels. Managing weight gain safely requires a personalized approach, ideally with guidance from a gastroenterologist and a registered dietitian.
Resources We Trust Cleveland Clinic: Crohn’s DiseaseMayo Clinic: Crohn’s DiseaseCrohn’s & Colitis Foundation: Overview of Crohn’s DiseaseYale Medicine: Crohn’s DiseaseMedlinePlus: Crohn’s Disease
