Weight loss is one of the most common symptoms of Crohn’s disease. In some cases, weight loss occurs slowly over time; in others, it may be sudden and unexpected. Weight loss with Crohn’s disease can cause feelings of weakness and fatigue and lead to malnutrition, making it difficult for your body to obtain the nutrients it needs to function optimally. (Source)

Learning how to gain weight with Crohn’s disease can be challenging, but it is certainly not impossible! With the right plan, you can achieve a healthy weight, helping you feel stronger and ensuring your body receives the nutrition it needs to function optimally.

Why Do People With Crohn’s Disease Lose Weight?

Weight loss in Crohn’s disease can be caused by insufficient calorie intake due to poor appetite and pain, impaired nutrient absorption in the gut, nutrient loss due to vomiting and diarrhea, mental health challenges, and the inflammatory process, which leads to a breakdown of the body’s own tissues. (Source)

Nausea and GI Upset

Nausea and gastrointestinal pain can lower your appetite, reducing your motivation to eat. Over time, this can contribute to significant weight loss. Additionally, vomiting and diarrhea can move food out of your body before nutrients have been absorbed, further contributing to weight loss.

Malabsorption

In people with Crohn’s disease, inflammation in the small intestine can impair your ability to absorb protein, carbohydrates, fats, vitamins, and minerals. This impaired ability to absorb nutrients is called malabsorption. Nutrient malabsorption is common in Crohn's disease, affecting 65%–75% of patients. (Source)

Stress and Anxiety

For some people with Crohn’s disease, stress and anxiety related to their condition may also reduce appetite. Worrying that certain foods will make their symptoms worse may cause some people with Crohn's disease to restrict their diets excessively. This may lead to reduced food intake and weight loss. (Source)

Inflammation

Some studies suggest that the inflammatory process involved in Crohn’s disease may also increase the body's energy expenditure — in other words, the body burns calories more quickly. As a result, it may be difficult for people with Crohn's disease to consume enough calories to make up for this excess expenditure, ultimately causing weight loss. (Source)

How to Gain Weight With Crohn’s Disease

Successfully gaining weight with Crohn’s disease involves brainstorming ways to nourish your body that are appealing and feel good to your gut, while reducing the inflammation that hinders nutrient absorption. Let's discuss 9 proactive steps you can take to gain weight with Crohn's disease to feel strong and resilient again!

1. Don’t Restrict Your Diet Too Much: Focus on What You Can Eat

Changing your diet can help reduce Crohn's disease symptoms and improve your quality of life. However, it’s crucial not to restrict your diet too much. Excessively limiting your food options may make eating feel burdensome, causing your appetite to dwindle.

Work with your health care provider to determine which dietary triggers are most essential for you to avoid, and brainstorm a wide array of foods you can include in your diet to whet your appetite and nourish your body. For example, if spicy foods or raw vegetables trigger symptoms for you, support your gut by steering clear of these foods and focus on the abundance of foods you can eat.

2. Keep a Food Journal or Track Your Food in an App

Keeping a food journal, in which you write down what you eat and how you feel after eating, can help you identify which foods flare your Crohn’s symptoms and which foods you tolerate well. This can help take the guesswork out of deciding what to eat, and give you peace of mind about which foods you can eat.

Logging your food in a food tracking app, such as MyFitnessPal or Cronometer, is also an option. One of the benefits of using an app is that it will provide you with feedback about how much you're eating, helping you identify ways to increase your food intake to support weight gain.

3. Work With a Nutrition Professional 

Regaining weight lost due to Crohn's disease necessitates increasing your calorie intake and optimizing your intake of protein, carbohydrates, and fat, collectively known as macronutrients. You may need to gradually work on eating more than you’re used to — in some cases, a lot more! A nutrition professional, such as a WellTheory Certified Nutritionist and Registered Dietitian, can help you determine the proper calorie and macronutrient targets you need to aim for to support healthy weight gain.

4. Follow an Anti-Inflammatory Diet

Since inflammation is a significant part of what promotes weight loss in Crohn's disease, controlling inflammation through dietary choices is vital.

The autoimmune protocol (AIP) diet has been found to reduce intestinal inflammation and improve symptoms of Crohn's disease. While research hasn’t shown AIP specifically leads to weight gain for those with Crohn’s, it could promote a healthy weight by increasing nutrient absorption and alleviating symptoms that adversely affect appetite. (Source)

5. Incorporate Gut-Healing Foods

Since malabsorption is a root cause of weight loss for many people with Crohn's disease, repairing the gut is crucial for restoring a healthy weight.

Bone broth, for example, is one food that has traditionally been used to support gut health. Preliminary research suggests that anti-inflammatory compounds in bone broth can relieve inflammation in ulcerative colitis, another form of inflammatory bowel disease. Since Crohn’s disease and ulcerative colitis involve similar inflammatory pathways, bone broth could aid in inflammation reduction in Crohn's disease, too. (Source)

6. Consider Enteral Nutrition

An enteral nutrition formula is a liquid dietary regimen that can help supply your body with nutrition if a symptom flare-up makes it hard for you to eat solid food. You can drink an enteral formula or, if you find it hard to tolerate, a feeding tube can be used temporarily to bypass your mouth and deliver the formula directly into your stomach. Enteral nutrition has been shown to support healthy weight gain, decrease inflammation, and improve well-being in people with Crohn's disease. Because enteral nutrition needs to be personalized for the individual, it must be overseen by a health care provider. (Source)

7. Eat Calorie-Dense Meals and Snacks

Make the most of mealtime by eating nutrient-dense foods that are also high in calories. Nourishing foods that pack a caloric punch include avocado, coconut, nut butters, and full-fat fermented dairy products such as yogurt (if you tolerate dairy).

Smoothies provide an easy-to-digest way to consume significant calories and nutrients. For a nourishing liquid meal or snack, you can fill smoothies with full-fat coconut milk, nut butter, leafy greens, avocado, and protein powder.

8. Eat More Frequently

If you tend to feel full quickly at meals, you can pack in nutrition by limiting how much you eat in each sitting and increasing your daily meal frequency. For example, instead of eating 3 medium-sized meals daily, aim for 6 smaller meals spaced evenly throughout the day.

9. Increase Muscle Mass

Inflammatory bowel disease, including Crohn’s disease, can cause sarcopenia, a loss of muscle mass. Approximately 50% of people with Crohn’s disease have sarcopenia, and this loss of muscle mass may account for a portion of the weight loss seen in Crohn’s patients. (Source) 

Loss of muscle mass eventually leads to loss of muscle function, affecting strength, mobility, and overall quality of life. Research shows that aerobic exercise and resistance training can help people with inflammatory bowel disease build muscle mass, and therefore may support a healthy weight in Crohn’s disease. Consult with your health care provider to learn more about how to safely incorporate aerobic exercise and resistance training into your routine. (Source) 

The Bottom Line on How to Gain Weight With Crohn’s Disease

Weight loss can occur for various reasons in Crohn's disease, leading to fatigue and weakness and potentially depriving your body of the nutrients necessary for healing. Reducing inflammation and emphasizing nutritious, calorie-dense foods can help you gain weight with Crohn’s disease. Regaining lost weight can take time, but WellTheory’s care team can help you get your weight moving in a healthy direction and feel better while living with Crohn's disease!