Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD) that causes inflammation and ulcers inside the inner lining of the intestine. Weight loss is often associated with UC, but some people may experience weight gain.
UC is an autoimmune condition in which the immune system mistakenly attacks the large intestine. Alongside weight changes, common symptoms include diarrhea, blood in the stool, pain in the abdomen, abdominal cramping, and rectal bleeding.
Some people may also experience fatigue, fever, nausea, or vomiting.
This article examines the possible causes of weight gain with UC. It also discusses how people with the condition can lose weight, if necessary, and includes the personal experience of Caitlin, a travel blogger who lives with UC.
Several factors may cause a person with UC to experience weight gain. A 2016 study reported that
UC itself does not necessarily cause weight gain, with researchers stating there is no known association between IBD and obesity. However, many factors relating to UC may cause weight gain, such as certain medications doctors prescribe to help treat the condition.
During a UC flare, people may reach for more convenient and less nutritious foods, resulting in weight gain. Flares may also lead to a person participating in less physical activity, which may contribute to weight gain.
Additionally, some 2021 evidence suggests possible shared environmental risk factors between IBD and obesity.
Caitlin’s story: I didn’t understand why I couldn’t lose weight
“Weight was something that I struggled with before being diagnosed and I couldn’t understand why I couldn’t lose weight.
“Since I have been diagnosed, my body has struggled with medications, and some keep me in the restroom for too long so that I can’t work out and feel defeated. This has led to issues with my mental health as well.”
Although many people may think of UC as a condition that causes weight loss, it can also contribute to weight gain. There are many reasons for this, including:
Limited exercise
Some people may find it difficult to motivate themselves to exercise when experiencing a flare of symptoms.
Although people with UC should aim to continue exercising regularly, they may find that lower energy levels prevent them from being active. Healthcare professionals can suggest the most suitable forms of exercise to attempt during a flare.
Medications
Corticosteroids, such as prednisone, are medications that reduce inflammation.
One possible side effect of prednisone, as well as other corticosteroids, is weight gain. Weight gain may continue even after a person stops taking the medication, and it can be challenging to reverse.
Other medications to treat UC also have links to weight gain, such as anti-tumor necrosis factor-alpha drugs.
No specific food or diet will help everyone who experiences weight gain from UC lose weight. However, the following weight loss tips may help people moderate their weight.
Maintain a healthy diet
People with UC can consider eating a well-balanced diet full of nutritious foods, including:
- Fruits and vegetables: People can try a variety of fruits and vegetables and remove the peel and seeds if they trigger a flare.
- Fiber-rich foods: These include whole grains, beans, nuts, oat bran, and barley. These foods are unsuitable for people with an ostomy or intestinal narrowing, and a person should avoid them if a doctor has advised them to follow a low fiber diet.
- Calcium-rich foods: These foods include milk, yogurt, kefir, lactose-free dairy products, and collard greens.
- Protein: Lean meats, fish, tofu, nuts, and eggs are good sources of protein.
- Food with probiotics: People can try including more yogurt, miso, sauerkraut, tempeh, and kimchi in their diet.
When experiencing a flare, a person may tolerate moderate portion sizes of the following foods:
- low fiber fruits
- lean protein, such as fish, poultry, soy, and eggs
- refined grains, such as sourdough, white pasta, potatoes, and oatmeal
- vegetables that are fully cooked and do not contain seeds or skin
Specific diets that a person may wish to discuss with a healthcare professional include:
- the Mediterranean diet, also known as the anti-inflammatory diet or IBD-AID
- the Paleolithic diet
- omega-3 enriched diets
- semi-vegetarian diets
- fasting diets
Some people with UC may experience malnutrition due to their bodies not absorbing all the vitamins and minerals they consume. These individuals should discuss any significant changes in their diet with a healthcare professional.
Caitlin’s story: Finding a diet that works has been trial and error
“The dietary changes have been huge for me — I haven’t eaten gluten since I was a young teenager, which has helped. As I have gotten older, my symptoms have only increased in severity.
“I tried the FODMAP diet that was recommended by my gastroenterologist and I was able to learn that onions, garlic, apples, and other foods mess with my digestive system. I also tried the ketogenic diet for about 6 months, and I was strictly vegan for 1.5 years.
“It’s been a lot of trial and error. Unfortunately, it has taken years to understand what is a trigger, and I am still learning every day.”
Stock up on nutritious, convenient foods
People experiencing a UC flare may eat unhealthy “junk” foods for convenience rather than seeking healthier alternatives.
Stocking cupboards and the refrigerator with quick, nutritious foods that are enjoyable can help people make food choices that are better for their health and prevent them from snacking on non-nutritious foods.
Avoid trigger foods
Caitlin’s story: Learning my trigger foods has been essential
“The moment I eat something that my body doesn’t like, I end up with stomach pain, headaches, vomiting, nausea, extreme stomach pains, and worsened constipation.
“For a while I had a food diary. This was helpful because I was tracking everything I was eating and how I felt after it. That gave me an understanding of what I had eaten that day that may have triggered my stomach.”
Researchers have found that some foods may be more likely than others to cause a person with UC to experience a flare. Some of these foods, such as those high in sugar and fat, can also contribute to weight gain.
By reducing their consumption of foods high in sugar and fat, people with UC may prevent weight gain and decrease flares.
Try a gluten-free diet
Some people with IBD find that cutting out gluten helps improve their symptoms. However, no research currently proves this claim. Furthermore, the Crohn’s & Colitis Foundation notes that gluten-free products often contain a higher fat content, contributing to weight gain.
Drink plenty of water
Drinking a glass of water about half an hour before meals can help people feel fuller and eat fewer calories. People who drink water before meals may lose
This habit is also beneficial because it is crucial for people with UC to stay hydrated due to the loss of fluids from diarrhea.
Caitlin’s story: I stay hydrated and avoid carbonation and straws
“I drink a lot of water throughout the day and stay hydrated, and I avoid drinking through a straw or anything with bubbles.
“I don’t drink alcohol very often or limit the types of alcohol when I do. I save this more for special occasions and drink wine or gin and tonics because I know that those don’t upset my stomach as much.”
Chew slowly
As well as allowing the brain time to detect satiety, chewing more slowly and thoroughly ensures that the body breaks down food before it reaches the stomach and gastrointestinal (GI) tract.
By chewing slowly, a person is also less likely to introduce air pockets into their GI tract, which can cause gas and discomfort for people with UC.
Exercise regularly
Caitlin’s story: Working out has improved my physical and mental health
“Working out has helped me with weight management, but the mental benefits are also extreme.
“I make sure to get some type of physical fitness 6 times a week. That could look like strength training, yoga, longer walks, running, HIIT workouts — I try to keep my body ‘on its toes’ and have felt that that has helped over having the same workout regime over and over.”
According to the
Going for a short daily walk could help people lose weight and prevent weight gain. Regular physical activity can help improve sleep, memory, and the ability to think and learn.
Other strategies that may help someone lose weight include:
- Cutting down on alcohol: Drinking alcohol can cause a person to experience symptoms of UC and gain weight. People who drink alcohol may find that reducing their intake is an easy way to lower the number of calories they consume.
- Reducing plate size: People can reduce their portion sizes by replacing their dinner plate with a side plate. A small plate gives the illusion of a full plate while decreasing the portion size.
- Improving sleep hygiene: Getting enough sleep can help a person lose weight. Older research suggests that low quality sleep is a
risk factorTrusted Source for weight gain.
Caitlin’s story: Sticking to a routine is helpful, but tricky
“I am someone who unfortunately needs a routine…but I love socializing. It is a double-edged sword. If I spend time with friends or family, my cup is full and I am thankful for them, but I am the person who goes into the day or night with a time in my head of “I have to leave at ‘x’ time.”
“Sticking to my ‘rules’ with myself is important. I’m not perfect and I have days where I stay and have fun and make those memories, but I will always pay for it the next day with headaches, extreme fatigue, mental, and gas or bloating.”
Although people do not usually associate weight gain with UC, it is not uncommon for the condition to have this effect. People with UC may need to monitor their weight to counteract any weight loss or gain due to the condition.
Some people with UC may be unable to lose weight due to their medications. Others may have difficulty getting enough exercise when their symptoms flare up.
If necessary, people with UC can try to lose weight by:
- eating a nutritious, well-balanced diet
- ensuring that they have healthy snacks available
- avoiding trigger foods
- trying a gluten-free diet
- drinking enough water
- chewing foods slowly
- getting regular exercise
Maintaining a moderate weight is key to reducing the risk of developing several other health conditions.
