Celiac Disease: Is Weight Loss Surgery Safe?

B.S. Dietetics, Dietitian, Health Professional
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As a dietitian, I have always sought first and foremost to teach people the proper way to eat, so that they can shed weight in a healthy manner. That said, there is a time and a place for weight loss surgery, and only you and your physician can determine whether it is right for you. If you have celiac disease (CD), however, there are some concerns that you will need to address in order to get through weight loss surgery in a healthy way.

CD affects roughly three million Americans. The condition is caused by an immune response to the ingestion of the protein gluten. This response damages the lining of the gastrointestinal tract and can lead to painful symptoms, including weight loss. However, not everyone with CD loses weight. Sometimes, a diet full of junk foods — whether gluten-free or not — can still lead to weight gain or obesity.

While there are no statistics on how many CD patients have undergone weight loss surgery, approximately 500,000 Americans had some form of bariatric surgery between 2011 and 2013. The three main types of weight loss surgery are the Adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), and the Vertical sleeve gastrectomy (VSG). Each surgery works by limiting the amount of food you are able to take in. Most people will initially lose weight after the surgery, but many gain some of it back. However, keeping off the weight is not a quick fix; rather, it requires lifelong changes to your eating habits. In order to keep off the majority of the weight, you will want to follow the healthy eating plan your doctor outlines for you.

One of the concerns for people with CD is that weight loss surgery can potentially produce nutrient deficiencies. Your physician will want to check for any nutrient deficiencies before allowing you to go ahead with weight loss surgery. Because people with CD are already at an added risk for nutrient deficiencies due to mal-absorption, it is imperative that you follow a gluten-free diet that is rich in protein and minerals. Some great gluten-free sources of protein include eggs or egg whites, skinless chicken, lean meats, fish, and low-fat dairy, like Greek yogurt.

There will be some minerals that you will not absorb very well, so it is important to be diligent in taking any supplements your physician recommends. Failing to adhere to your doctor’s orders can cause nutrient deficiency, anemia, bone density issues, hair loss, and other problems. Most frequently, your doctor will recommend a multivitamin with iron, vitamin B12, calcium (1200 milligrams per day), and vitamin D. Check the labels on any of your supplements, because some filers may contain gluten. Be sure that yours are gluten-free to prevent added discomfort.

If you have CD, it does not automatically eliminate you as a candidate for weight loss surgery. However, it is important to consider the issues outlined above and speak with your physician before proceeding with surgery. Only your physician can decide whether the benefits outweigh the risks to your overall health.

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