Strategies to Gain Weight with Crohn's and Ulcerative Colitis
Discover tips for managing weight gain safely with Stacey Collins Nutrition.
Gaining weight can, at times, be challenging for some individuals living with Crohn's disease or ulcerative colitis due to the nature of these inflammatory bowel diseases (IBD). Malnutrition, malabsorption, nutrient deficiencies, and digestive discomfort are common challenges to maintaining a healthy body composition. However, with appropriate dietary strategies and professional guidance, achieving weight gain and improving overall health is possible. Here in my virtual nutrition private practice, I provide personalized support as a trusted registered dietitian to help individuals with Crohn's and ulcerative colitis navigate their nutrition challenges and safely achieve weight restoration if that is a person’s goal. I'm here to guide you through the process with care and expertise tailored to your needs.
Note from the Author, Stacey Collins, MA, RDN/LD
This article focuses around weight gain and restoration as a primary goal. This is not everyone’s goal, and it may not be a safe or sustainable goal for people with a history of eating disorders. Please use discretion before reading this article, and skip this topic of weight if it risks being a challenge to your mental wellbeing. Nutrition therapy is a highly personalized intervention and an appropriate goal for one person is not a universal approach for all;
there’s always room to explore progress and health using metrics outside of weight.
Understanding the Challenges of Weight Gain with Crohn's and Ulcerative Colitis
Both Crohn's disease and ulcerative colitis can cause significant digestive disruptions, leading to challenges with digestion, poor nutrient absorption and unintentional weight loss at times. Inflammation in the digestive tract can increase the body’s nutrient demands for healing, meaning that more nutrients and food intake are required during this process. Consequences of active disease and inflammation may be nutrient and vitamin deficiency/insufficiency and/or malnutrition. Additionally, symptoms like diarrhea, constipation, nausea, abdominal pain, and the inflammatory process itself can reduce appetite and make eating a daunting task. Understanding these challenges is the first step in creating an effective weight gain strategy.
Nutritional Strategies to Promote Weight Gain
1. Focus on Calorie-Dense Foods: When trying to gain weight, consuming more calories than your body burns is important. Calorie-dense foods like avocados, nuts, seeds, and olive oils can help increase your calorie intake while providing more nutrition in smaller volumes, which may be more comfortable than larger volumes of food. This is one example of an easy way to provide your body with “nutrition-per-bite” to help your body get the energy and nutrition from foods that are needed for healing from flares and/or surgery.
2. Incorporate Protein-Rich Foods: The digestive tract is made up of muscle, and protein is essential for both smooth and skeletal muscle repair and growth, wound healing, and a host of functions within each bodily system. Include complete proteins from plant-based pairings, like grains and legumes, or tofu, and edamame, as well as lean proteins such as poultry, omega-3-rich fatty fish, like salmon, and/or eggs.
Protein shakes or smoothies can also be a great way to add extra protein to your diet in a form that's easy on your digestive system, but you need to ensure that the protein is 3rd party tested for quality assurance to ensure what’s on the label is what’s actually in the ingredients.
A word of caution: increasing too much protein too quickly without enough fiber from plants and hydration can lead to greater GI discomfort and distress. Make sure to work with a dietitian to explore your body’s specific protein goals, both inside and outside of active inflammation from disease, and work together to safely increase the protein in your diet.
3. Opt for Frequent, Small Meals: Eating smaller, more frequent meals throughout the day can be easier for your digestive system than consuming large meals. This approach helps maintain a steady intake of calories and nutrients without overwhelming your system. Planning for additional meals from whole food sources may require more time and energy, which can be taxing if you are feeling fatigued from the burden of active inflammation.
At Stacey Collins Nutrition, I offer personalized nutrition assistance to help you create balanced, nutritious meals. My goal is to promote a sustainable, practical approach to eating that feels manageable and enjoyable, rather than overwhelming. Together, we’ll make healthy eating simple and tailored to your lifestyle.
4. Consider Nutritional Supplements: Depending on your body’s specific needs, nutritional supplements might be necessary to help you meet your calorie and nutrient requirements. Supplements such as protein powders, and/or oral nutrition shakes (ONS), which are specialized medical formulas are tools that can provide extra nutrition when solid foods are difficult to consume. As a registered dietitian, I enjoy guiding people to select quality supplements in quantities that are safe and palatable for you.
Managing Active Disease Flare-Ups While Trying to Gain Weight
During these times when disease is active and symptoms are challenging, focusing on gentler approaches to nutrition in easy-to-digest textures. These might include options like:
Peeled and cooked-down vegetables that are fork-tender against the roof of your mouth
Smoothies, soups, and stews
Cooking food in broths instead of water may provide extra nutrition and additional protein
Applesauce instead of whole apples; peeled/roasted mashed potato instead of potato with skin; nut/seed butters instead of whole nuts and seeds, for example
If fatigue is a major issue and you are tiring while eating, prioritize consuming protein-rich foods in the meal, and ensure that hydration remains a top priority.
Dehydration is important to prevent, slowly sipping water throughout the day and salting your foods for added electrolytes, especially if you are experiencing night sweats, or running to the bathroom with more frequent bowel movements. Symptoms can worsen symptoms, put strain on bodily functions, and even hinder weight gain.
Look out for signs of dehydration in your body:
feeling dizzy when you stand up
feeling tired
getting headaches
having muscle cramps
feeling like you can’t drink enough
having a dry mouth and cracked lips
not peeing as much (less than 1200 mL in 24 hours)
urine that is darker in color (although certain vitamins and medications can change the color)
Low blood pressure
The Importance of Monitoring and Adjusting Your Diet
Regularly monitoring your disease and your progress are important as you work towards weight gain and restoration. Monitoring of disease-related activity should occur with your GI team and may include labs to check inflammatory markers, endoscopic procedures to check for mucosal healing of your digestive tract, and/or check-ins to see how your symptoms are improving. Nutrition monitoring with a dietitian will require adjustments to your diet and/or supplements based on your symptoms and/or your labs, with possible monitoring through a scale if weight gain and restoration is the primary goal. Other routes can be used to monitor changes in body mass if the scale is not a useful measurement for you, such as clothes fitting tighter, energy levels when climbing stairs, appetite improvements, and more.
How Stacey Collins Nutrition Can Support You
Managing Crohn's or ulcerative colitis while trying to gain weight can be a delicate balance, but you don't have to navigate it alone. My specialty is providing people with personalized nutrition therapy tailored to your specific needs and preferences, ensuring your diet is nutritionally complete to support your body to gain weight in a healthy and sustainable manner, if that is your primary goal.
With professional guidance, you can overcome the challenges posed by Crohn's and ulcerative colitis symptoms, improve your nutrient intake, and achieve your weight gain goals, even on the days when it feels like nutrition doesn’t make much sense . Whether you're experiencing a flare-up or maintaining remission, I’m here to support you every step of the way.
Ready to embrace the journey of nourishment? Let's get started, please reach out today!!
