When everything is flowing smoothly, life is good. And we’re not just talking good hair days or a flawless presentation at work. Your digestive tract counts too. But when it’s out of whack, it could affect the scale.
‘Gastrointestinal and digestive issues can definitely have a large effect on the way we eat and how our bodies absorb and digest foods, causing us to gain or lose weight,’ says Dr Kenneth Brown, a gastroenterologist. ‘Most digestive problems tend to cause weight loss from poor absorption of food, but there are a few situations in which our intestinal health can contribute to weight gain.’
If the number on the scale is rising and you really aren’t sure why, one of these six common digestive issues could be the culprit:
1. Acid reflux
Also known as gastroesophageal reflux disease (GERD), this causes a painful burning sensation, or heartburn, in the lower chest when stomach acid rises back up into your oesophagus. And for people who suffer from it, the term ‘comfort food’ takes on a whole new meaning because the act of eating can actually help reduce pain. ‘Eating provides temporary relief because both the food you’re eating, and the saliva from actually chewing that food, neutralises acid,’ explains Brown.
The only problem? Once the food’s been digested, all the symptoms – bloating, nausea, hiccups that won’t disappear – tend to come back, and they’re usually more aggressive because of rebound acid production. But because people want help, Brown says a lot of people tend to get sucked into a dangerous cycle of overeating that leads to weight gain.
While plenty of online sources say home remedies like apple-cider vinegar or aloe vera can help, Brown says there’s no scientific evidence to support those notions. Instead, he recommends taking an over-the-counter medication, such as omeprazole or ranitidine (your doctor can help you choose which is best for you), which don’t have weight gain as a common side effect.
These uncomfortable sores, also known as duodenal ulcers, usually develop in the lining of the stomach or small intestine, and it’s usually because of too much acid production. And just like with GERD, eating food can improve the painful symptoms – including bloat and constant nausea – because it temporarily coats the ulcer with a protective lining and neutralises the stomach acid, explains Dr Su Sachar, a gastroenterologist who specialises in bariatrics, wellness and optimal health. And, to restate the obvious, if you’re eating more frequently, those excess kilojoules can lead to weight gain.
To banish ulcers, see your doctor about the best remedy for you, which might involve an acid-blocking medication (aka an anti-acid). And stop taking nonsteroidal anti-inflammatory drugs – or NSAID pain relievers – like ibuprofen or aspirin, as they could cause internal bleeding and be life-threatening to those with ulcers. Instead, opt for paracetamol when you need help with pain management.
When you’re feeling stopped up, that weighed-down feeling you get could be weight gain. But there’s good news: your body isn’t actually absorbing more kilojoules, says Brown, so it’s not true weight gain so much as it is extra faecal matter, which is what could be adding a few kilos to the scale.
Not to mention that constipation itself doesn’t exactly give us the motivation to hit the gym and crush a workout. Rather, it’s much more likely that you’re feeling sluggish and heavy … and the couch is calling your name.
To stay, er, regular, Brown suggests sticking to a balanced diet of whole foods that have at least 25 to 30 grams of fibre per day, staying well-hydrated (try to drink one to two litres of water per day) and exercising regularly.
4. Bacteria overgrowth
Bear with me – this one isn’t quite as gross as it sounds. Basically, your bowel contains both good and bad bacteria, and research shows that the good kind plays a crucial role in your overall health by reducing inflammation and keeping your weight in check.
The problem occurs when the amount of bacteria increases, or when the type of bacteria gets thrown off-balance (for optimal health, it’s best to think of it like a seesaw – best when the good and bad is totally balanced). When that happens, what’s known as small intestinal bacterial overgrowth (SIBO) can occur, and it can cause weight gain in two ways, says Brown.
First, the bacteria could produce methane gas, which ‘slows down the overall function of the small intestine, allowing the intestinal villi – small, finger-like projections in the lining of your intestine – to absorb more kilojoules per bite,’ he explains.
In other words, the exact opposite of what you want to happen. Second, SIBO can slow down metabolism and affect your insulin and leptin resistance, both of which help regulate hunger and satiety. As a result, you’re likely to crave carbs and probably won’t feel full after eating, even if it’s a fully satisfying meal, says Sachar.
To avoid SIBO, Brown suggests avoiding antibiotics unless absolutely needed. Or consider trying a probiotic to get you back on track.
5. Irritable bowel syndrome (IBS)
The term IBS gets tossed around a lot these days, as ‘it’s the most commonly diagnosed GI condition, and it often overlaps with other digestive problems like food sensitivities, a leaky gut and an imbalance of good and bad bacteria,’ says Sachar. And like constipation (a symptom of IBS), it can cause bloat and chronic inflammation, which, once again, could lead to weight gain.
For people who are diagnosed with IBS, it’s about getting to the root of the problem. Your doctor can work with you to build up the good bacteria you need with probiotics, and add digestive enzymes to help break down food so it’s not just sitting around in your gut causing inflammation, explains Sachar.
Brown says it could be helpful to try a gluten-free or low gas-producing diet, like FODMAP, as it can help reduce bloating and help get any unnecessary weight gain under control.
Related: 7 reasons your urine smells odd
6. Crohn’s disease or ulcerative colitis
While a smaller appetite and excessive weight loss are common symptoms of both Crohn’s disease and ulcerative colitis (both of which are incurable chronic inflammatory conditions), the exact opposite can happen as soon as someone gets put on a treatment that involves steroids – which is usually the first step in trying to find a medication that works for you, says Sachar.
‘Steroids tend to increase your cravings for carbs and cause you to hold on to more water and feel bloated,’ says Sachar. ‘An oral steroid like prednisone can also cause your body fat to redistribute itself, so instead of it being in your stomach or glutes, it could move to the face or neck.’
Fortunately, it’s usually not too tough to lose the weight once you’re off steroids. That usually happens as soon as a flare-up – or the reappearance of symptoms like diarrhoea, constipation, rectal bleeding and fever – subside and symptoms are better under control.
First of all, your overall health is more important than a few kilos on the scale, so following your doctor’s orders is imperative. But some doctors do shy away from steroid use, like Brown, as he knows the side effects can be less than desirable. Every patient responds differently to medication, though, so talk with your own physician to see what works best for you.
From: Redbook US