There continues to be a lot of debate and confusion about gluten, an ingredient that has been consumed by humans for thousands of years. It is a common ingredient surrounded with a lot of misconceptions about its relation to our health and weight. So is gluten a friend or foe?  Since we are all unique individuals with different health concerns, the answer is ultimately, it depends.  

Individuals who have gluten sensitivity or celiac disease are advised to avoid gluten, typically as the primary treatment option. Although gluten itself does not cause weight gain for most individuals, it is an ingredient in many high calorie, highly processed foods that tend to dominate a typical American diet. . Overconsumption of these foods may be a contributing factor to weight gain.  But does that mean that gluten is off limits completely?  This article will cover what gluten is and where it is found, who needs to avoid it and why, and what role gluten plays in inflammation and weight gain.

What is gluten? Does gluten cause weight gain?

You may be surprised to learn that gluten is actually a protein. It is the main protein found in wheat and other grains such as barley and rye. Therefore, foods that have a high amount of gluten (unless labeled “gluten free”) include bread, buns, rolls, bagels, biscuits, flour tortillas, pasta, cereal, crackers, beer, soups, malt, and gravy. Sometimes gluten is found in oats due to exposure or manufacturing in close quarters with foods that do have gluten but oats do not naturally contain gluten.  Gluten is a naturally occurring ingredient but it can be added to foods to add protein, flavor, and texture. It acts as a glue to hold foods together and to help maintain their shape or that stretchy quality (think a fluffy loaf of bread or pizza dough!)

Many people who follow a gluten free diet are confused why they continue to experience weight gain or fluctuations in blood sugars. One reason this can happen is that they replace foods that contain gluten with a high volume of gluten free foods that contain sugar, sodium, and other low nutritional value additives that are not supporting their health or weight loss efforts. These extra ingredients are meant to improve the taste and mouthfeel of gluten free foods. Some commonly consumed packaged gluten free foods are higher in carbohydrates and fat and lower in iron, folate, and protein compared with regular products. These packaged products are considerably less nutritious than whole food sources like vegetables, fruit, nuts, seeds, and lean protein. 

Despite ever growing sales of gluten-free foods over the last few years targeting support for weight loss and chronic medical conditions, there is minimal research to support the use of a gluten free diet for weight loss . In 2013, there was a study using mice that suggested gluten exposure was associated with weight gain, but it failed to pinpoint why this association occurred. Follow up studies were also inconclusive. To date, no studies have used human subjects to understand how consumption of gluten impacts health. 

Individuals with undiagnosed or untreated celiac disease may experience unintended weight loss over time due to malabsorption of nutrients caused by damage and inflammation to the intestine and the body’s organs and tissues. However, when the intestine heals after starting a gluten-free diet, lost weight is sometimes re-gained and weight gain can continue.

Gluten sensitivity and weight gain

A gluten sensitivity, or intolerance, may be diagnosed if an individual experiences negative symptoms like fatigue, nausea, or bloating after eating gluten. Sometimes a medical provider will first rule out celiac disease or a wheat allergy before diagnosing a gluten sensitivity. Gluten sensitivity and celiac disease cause similar symptoms,but people with gluten sensitivity don’t have an abnormal gene or antibodies in their blood that are present in those with celiac.  Essentially, a gluten sensitivity diagnosis is made after celiac disease or allergies are ruled out and an elimination diet is trialed with positive results. During an elimination diet, problem foods are identified and removed from the diet. As a result, negative symptoms associated with these foods are also decreased or resolved. An elimination diet should be done under  the guidance of a Registered Dietitian to ensure adequate nutrition during the trial with  a thorough evaluation of caloric intake and quality, especially if there are concerns regarding weight.

Celiac disease and weight gain

An autoimmune response to gluten is called celiac disease. In this case, gluten is mistaken as a toxin, causing an individual's immune cells to overact and send inflammatory cells and antibodies to destroy the gluten molecules. Over time, this results in inflammation and damage to the finger-like projections of the small intestine called villi. If the villi get damaged, they can’t absorb important nutrients which can cause very uncomfortable symptoms such as fatigue, bloating, constipation and/or diarrhea, unintentional weight loss, and malnutrition.

The only treatment for celiac disease is a completely gluten free diet. This lifestyle change can be challenging to navigate and sometimes results in a gradual healthy regain of weight that may have been unintentionally lost, but can also result in unwanted weight gain if a balance of nutrients (even if gluten free) does not exist.  These individuals can benefit from working with a Registered Dietitian to help navigate these challenges. 

What to do if you suspect weight gain is caused by gluten or gluten sensitivity

Talk to your doctor or dietitian if you think gluten could be affecting your weight or your health. Your doctor may suggest a blood test or other workup to detect celiac disease, a wheat allergy, or another underlying condition. A dietitian can help with a thorough evaluation of your food patterns and symptoms to build an eating plan that feels good for you. A dietitian may suggest keeping a detailed food and symptom journal to better identify any consistency with foods that are potentially problematic but also to build an eating regimen to support individualized health and weight goals. Exploration of sleep quality and adequacy, stress management, and physical activity are other important considerations when discussing weight loss goals with a medical provider.   

Gluten: Friend or foe? 

Weight gain is complex. Far more often than not, gluten is not the only culprit for weight gain. For centuries, foods with gluten have been providing people with valuable nutrients: protein, soluble fiber, and B vitamins. Gluten in itself, especially gluten found in whole grains, is not bad for healthy people whose bodies can tolerate it. 

If you have tried to lose weight on your own, without success, Form Health can help! Thorough exploration of nutrition, sleep, stress, family and medical history, lifestyle,, and physical activity by  our expert clinical team will  help identify opportunities to improve nutrition and physical activity habits to support your weight loss efforts. Take our quiz to find out if you are eligible.