Obesity is Common in Individuals with Celiac Disease


In an abstract presented at Digestive Disease Week 2024, researchers analyzed the prevalence of obesity in patients with and without celiac disease.

Researchers found a significant prevalence of obesity in patients with celiac disease (CD) compared to those without CD. Furthermore, they found obesity most prevalent in CD patients aged 65 years or older and patients who are White. This is according to a poster presented at Digestive Disease Week (DDW) 2024.

“There are several pathophysiological pathways that connect obesity and CD such as the gut microbiome. Both conditions have been associated with gut microbiome alterations including high levels of the Firmicutes phylum such as the Lactobacillus species,” wrote the authors of the poster.1

The gut microbiome plays a significant role in the development or existence of both obesity and CD. Researchers aimed to compare the 2 conditions while addressing the role the gut microbiome plays in diagnosing and exacerbating both either.

“The gut microbiota is a rich and dynamic ecosystem that actively interacts with the human body, playing a significant role in the state of health and disease of the host. Diet, exercise, mental health, and other factors have exhibited the ability to influence the gut bacterial composition, leading to changes that can prevent and improve, or favor and worsen, both intestinal and extra-intestinal conditions,” wrote Matute et al.2

Key Takeaways

  • Researchers analyzed the prevalence of obesity in patients with and without celiac disease (CD).
  • Of all patients with CD who participated in the study, 32.2% also had obesity.
  • The results caused researchers to encourage more research into microbial changes and dietary exposures.

Researchers analyzed 2 groups of participants, patients with and without CD, and separated them by characteristics including gender, age range, and race, then measured the prevalence of obesity in each group. Obesity was identified if patients reported a body mass index of over 30 kg/m2.

Woman refusing bread

Researchers identified the gluten-free diet as a potential risk factor for obesity in CD patients. | image credit: nicoletaionescu / stock.adobe.com

Of 407,333 total study participants, 1844 had CD; the remaining 405,489 did not. However, of these 2 cohorts, 32.2% of patients with CD had obesity, while only 18.41% of patients without CD had obesity.Obesity among women with CD (52%) was more common than men with CD (44%). Among older adults with CD, 48% had obesity, which was significantly higher than patients with CD aged 18 to 44 years (9%) and those aged 45 to 64 years (43%).1

When analyzing patients by CD diagnosis and race, 50% of White patients with CD and 51% of White patients without CD had obesity.

“Our data show significant correlation between CD and increased prevalence of obesity, suggesting that obesity can be a direct symptom of celiac disease,” the poster authors noted.1

After finding a significant relationship between individuals with obesity and patients with CD, researchers addressed the potential gut microbiome properties that might commonly cause this correlation. They also explored ways to treat patients with both conditions, as well as the lifestyle choices that could exacerbate either.

“CD's initial presentation is mainly recognized in adults. Concurrently, obesity is gradually being acknowledged as part of CD's clinical course. In recent literature, both obesity and CD were shown to be significantly associated with alterations of gut microbiome. As adherence to a strict gluten free diet has been identified as extremely challenging or unfeasible in some patient cases, there is a great need for less restrictive adjunctive therapies,” the authors wrote.1

While high levels of the Firmicutes phylum are associated with gut microbiome alterations, other pathways, such as beta-oxidation or inflammation in the intestines, are also associated with the link between obesity and CD.

Researchers then suggested potential treatment options for the combination of both conditions, including probiotics rich in Lactobacillus and Bifidobacterium.

And finally, they identified the gluten-free diet as a potential risk factor for obesity in CD patients. “Some studies suggest that a gluten-free diet might contribute to the development of obesity in patients with [CD],” wrote the authors.1

“These results warrant further investigation into microbial changes and dietary exposures that affect the pathogenesis of both diseases with the goal of developing new therapeutic approaches,” they concluded.1

Click here for more of our coverage from Digestive Disease Week 2024.

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1. Addanki S, Mashukova AV, Levy A. Unraveling the link between celiac disease and obesity: a potential role of gut microbiome. Presented at: Digestive Disease Week 2024; May 18-21, 2024; Washington, DC.
2. Matute SP, Iyavoo S. Exploring the gut microbiota: lifestyle choices, disease associations, and personal genomics. Front Nutr. 2023;10:1225120. 2023 Oct 5. doi:10.3389/fnut.2023.1225120
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