Fluctuating weight is commonly seen in people with IBD, reflecting flare-ups and periods of remission. Weight loss can be a good indicator that you are not getting enough nutrients. You should tell your IBD team if you have lost weight unintentionally. Of course, not all people with IBD are underweight. For example, many people find that they gain weight if they are on steroid medication. This is often because steroids can increase your appetite, but it could also be due to fluid retention.
One reason for losing weight might be because you are not eating as much food as you need due to pain or discomfort. You may also have trouble absorbing nutrients from food because of inflammation in the intestines, bacterial overgrowth, or diarrhoea and vomiting.
Some medications can also suppress nutrient absorption: for example, steroids can reduce the absorption of calcium, and sulfasalazine can reduce the absorption of folic acid.
During a flare-up, it is important to try to maintain your weight. You may need to eat more energy and calorie rich foods. Try to follow healthy eating guidelines, as mentioned in the previous section, to help make sure you are not deficient in minerals and vitamins. Diets to increase or gain weight should be discussed with your IBD team to ensure that you are maintaining a healthy balance.
Ways to put on weight could include:
- Eating little and often throughout the day.
- Eating plenty of protein and energy rich foods.
- Drinking soups, juices and smoothies rather than just tea or coffee.
When in remission, it is still important to maintain a healthy weight. Putting on a bit more weight may act as a way to ensure that you have a ‘reserve’ should you have a flare-up in the future. If you are still having problems maintaining your weight through eating ordinary food, you could ask for a referral to a dietitian.
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