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The connection between celiac disease and obesity explored at DDW

May 29, 2024

Both conditions associated with changes in the gut microbiome, early study results show

By Amy Ratner, director of scientific affairs

Obesity was more common in those with celiac disease compared to those without celiac disease, analysis of a large national database of health information found in a study presented recently at Digestive Disease Week (DDW).

About 33 percent of people with celiac disease were obese compared to about 18 percent of those who do not have the condition, researchers from Florida’s Nova Southeastern University found in a study based on the All of Us Research Program. Run by the National Institutes of Health, the program aims to enroll one million participants who volunteer to contribute health data over many years.

The role of the microbiome

The researchers set out to investigate the prevalence of obesity in patients diagnosed with celiac disease and to analyze existing evidence on the alterations in the gut microbiome of celiac disease, exploring connections with obesity.

The role of the gluten-free diet in obesity in celiac disease was acknowledged by the researchers, but not explored in the study.

The research revealed similar alternations in the gut microbiome, for example, high levels of the Firmicute bacteria, in both those who have celiac and those who are obese.  The gut microbiome is made up of the trillions of microorganisms that live in the digestive system.

Obesity in varying populations

Women made up a greater portion of those who had celiac disease and were obese. Meanwhile, men with celiac disease were more like to be obese than men who did not have celiac disease. Age also played a role, with most of those who had celiac disease and were obese being older than 65. White people were more frequently obese than Black people, about 50 percent compared to 23 percent in both those who did and did not have celiac disease.

Obesity was defined as a body mass index (BMI) greater than 30.

The study was based on the review of data from about 407,000 participants, including about 1,800 with celiac disease. Those with celiac disease and control groups were matched by age range and health surveys.

Celiac disease and obesity were determined by a collection of medical terms that includes codes, terms, synonyms, and definitions for anatomy, diseases, procedures and electronic health record measurements, the study says.

The idea that celiac disease presents as chronic diarrhea in a malnourished child has largely been abandoned, study authors wrote in the research presented as a poster at DDW. They noted that celiac disease is now recognized as developing in adults and that obesity is “gradually being acknowledged” in the course of the disease.

The study calls for more investigation into changes in the microbiome and diet that affect the process of disease development with the goal of finding new treatments.

Role in development of new treatments

The findings of the study could potentially play a role in the development of new treatments that could influence the composition of the gut microbiomes and target the changes in normal functions that accompany and connect obesity and celiac disease.

In addition to the microbiome, the study suggests that slowed fat metabolism with poor absorption of carnitine, a substance produced by the body that turns fat into energy, in celiac disease may contribute to obesity.

DDW is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Studies presented at DDW are sometimes preliminary and give an early look at investigations that are likely to include more details as they progress toward publication in a peer reviewed scientific journal. Studies selected to be presented at DDW go through a review process.


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