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Are people with celiac disease always thin, or can they be overweight?

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Updated July 17, 2008

Question: Are people with celiac disease always thin, or can they be overweight?
Answer: Overweight people can definitely have celiac disease.

There are two main reasons why people often associate celiac disease with being very thin. First, years ago it was thought that celiac sprue -- which is what celiac disease used to be called -- only developed in babies and young children. These young patients were usually extremely underweight for their age and weren't growing appropriately, a condition generally called "failure to thrive."

Another reason why it was thought that celiac patients are always thin is that the disease damages the lining of the small intestine and causes a condition called malabsorption, in which nutrients can't be absorbed properly by the body. People with malabsorption are often underweight, which is why doctors did not usually consider a diagnosis of celiac disease in people who are overweight.

Now, however, medical research has been showing that people with celiac disease are not always thin. For example, in one study published in the Archives of Pediatric and Adolescent Medicine in 2008, 11.2% of children diagnosed with celiac disease were overweight. In another study in the American Journal of Gastroenterology published in 2001, 39% of adults with celiac disease were overweight when they were diagnosed.

In its Consensus Statement on Celiac Disease, the National Institutes of Health (NIH) cautioned doctors that, "The single most important step in diagnosing celiac disease is to first consider the disorder." These days, more and more doctors are realizing that the diagnosis of celiac disease should be considered in patients who are overweight, too.

Sources:

Dickey W, Kearney N. Overweight in celiac disease: prevalence, clinical characteristics, and effect of a gluten-free diet. American Journal of Gastroenterology 2006;101:2356-9.

Green PHR, Stavropoulos SN, Panagi SG; et al. Characteristics of adult celiac disease in the USA: results of a national survey. American Journal of Gastroenterology 2001;96:126-131.

Grzegorz Telega, MD; Tess Rivera Bennet, MD; Steven Werlin, MD Emerging new clinical patterns in the presentation of celiac disease. Archives of Pediatric and Adolescent Medicine 2008;162:164-168.

National Institutes of Health Consensus Development Conference on Celiac Disease

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