Obesity Among Children With Coeliac Disease

Objective: Coeliac disease is an immune disease with large portions of small intestinal villous atrophy causing weight loss, failure to thrive and other intestinal and extraintestinal manifestations. In spite of that, a part of these patients are found to be with normal weight, overweight and even obese.

Aims: To find the incidence of obese children among Coeliac diagnosed patients.

Methods: Data from the years 2008-2018 regarding age, height, weight, Body Mass Index (BMI), serology and histology of children aged 01-18 years old from the French Hospital of Nazareth diagnosed with coeliac disease were collected retrospectively.

Results: 190 children diagnosed with coeliac disease according to ESPGHAN criteria were included (64.2% females, average age 8.9 years, average weight 29.9 KG, average BMI percentile 44.7). At diagnosis 38 (20%) were underweight with BMI percentile below 5, 56.8% with normal weight, 28 (14.7%) overweight and 16 (8. 4%) obese. (Table 1)

Discussion: According to our study, fifth of these patients were underweight. That suits the clinical manifestation of the disease in which weight loss and failure to thrive are part of it. Still, over 50% had normal BMI, and the rest were overweight or obese. It is not clear why a disease that causes a small intestinal atrophy would present among overweight and obese children. An increased intestinal surface area and increased absorption through the rest of the normal intestine (Adaptation theory) may explain that.

Conclusion: Coeliac disease should be in mind even in an overweight or obese child presenting with relevant clinical or laboratory findings.