7 tips that helped me maintain my weight during an IBD flare

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Remember that you are worthy of your own love no matter what you look like or feel.

While most symptoms of inflammatory bowel disease (IBD) are invisible, weight loss is extremely noticeable and has a physical and mental impact on those who suffer from it.

Maintaining an adequate weight is often an ongoing challenge, as weight can fluctuate easily in people with IBD. In a culture that praises smaller bodies, we are sometimes even praised for losing weight, which is seen as a sign of health rather than a sign of an invisible chronic disease.

Losing weight and struggling to maintain a healthy weight with IBD is something that I have worked to balance for many years. During this time, I lacked self-confidence and self-esteem.

Even at times when I was feeling really good, I couldn’t go over a certain number on the scale. I often felt like I was disappearing in the air. I felt bones that people aren’t supposed to feel because they’re normally protected by fat which was scary and unnerving.

However, I have managed to gain weight and keep it off for the long term using the strategies outlined below.

The small intestine is where most of our nutrients from food are absorbed. Since the small intestine is involved in Crohn’s disease, this can be a significant barrier to weight gain and maintenance.

Even though ulcerative colitis (UC) only affects the large intestine, that doesn’t mean people with UC shouldn’t focus on healing the inflammation. This is because inflammation can result from gut permeability, bacterial and fungal overgrowth, food sensitivities, etc., and not just inflammation directly related to IBD. Additionally, inflammation in the large intestine presents its own concerns.

The more inflammation you have, the harder it will be for your body to absorb nutrients. This is detrimental to your chances of achieving adequate weight.

I saw an improvement in my weight when I made my diet simple but rich in nutrients. I left out some of the “fun” gluten-free snacks I enjoyed and focused on protein, grass-fed butter and extra virgin olive oil, bone broth. , teas and herbs.

I even swapped in some of the products I used on my skin and at home to eliminate them as a potential source of stress for my body.

To start curing inflammation, focus on an anti-inflammatory diet and incorporate the best foods for gut health.

In general, an anti-inflammatory diet is low in sugar and free from refined grains. Emphasis should be placed on whole foods such as high quality protein, fats, fruits, vegetables, nuts and seeds, and water as the primary source of hydration.

You may want to consider additional supplements like collagen, Ginger, Turmeric, tart cherry juice, and other foods or herbs that improve inflammation.

It’s important to assess what you eat on a typical day and see how you can optimize the types and amounts of your food. Not eating enough macronutrients, including protein, carbohydrates, or fat, can be detrimental, especially if you are already underweight.

When looking to gain weight, now is not a good time to cut down on macronutrients (I’m looking at you, keto.)

Try to prioritize whole macronutrients. What I mean is, choose sweet potatoes over bread. Choose chicken, beef and fish over protein powders. Opt for extra virgin olive oil, grass-fed butter (if tolerated), and coconut oil over vegetable oils. This provides nutrients that are much more easily usable and have health benefits.

Give yourself a mental checklist and make sure there is always protein, fat, and carbohydrates on your plate. You may want to work with a dietitian or nutritionist to make sure your portions are adequate for your goals.

Some foods contain more calories than others, which can be a good thing when trying to gain weight.

Fat contains the most calories per gram compared to protein and carbohydrates. Foods with higher fat content like coconut, avocado, walnuts – and products made from them – are foods to consider on a daily basis.

Start thinking about how you can add more of these high calorie foods to your diet.

When I needed to gain and maintain weight, I would add avocado slices to dishes, have smoothies between meals, and snack on rice cakes with nut butter.

An extra drizzle of extra virgin olive oil or avocado slices will add when making these choices consistently.

These are just a few ways to start including high calorie (but still high nutrient) foods on your plate.

It is common for larger meals to cause gastrointestinal distress in IBD. Larger meals during the day may trigger diarrhea in some, which is not helpful for weight gain.

If you experience gastrointestinal symptoms while trying to gain weight, eating small meals and snacks throughout the day will likely do you good and not cause additional symptoms in the long run.

To ensure you have access to plenty of food options that you can choose from on a daily basis, buy and prepare foods that are easy to grab. Some additional snacks that I have stored are:

  • boiled eggs
  • meat sticks or jerky
  • dried mango
  • yogurt
  • hot buckwheat cereal or oatmeal
  • bananas
  • Applesauce
  • grilled chicken strips
  • smoked salmon
  • gluten-free toast or waffle with jam and nut butter

Make sure to leave extra snacks where you work or wherever you spend time outside of your home.

It can be difficult to absorb enough calories without feeling like you’re eating all day.

Not only that, but everyone’s work or lifestyle cannot afford to eat so frequently.

This is where liquid nutrition can be a useful supplement to support a nutrient dense diet or to temporarily replace solid foods when needed.

Important Note: Research liquid nutritional supplements before you buy or start incorporating them. Some popular liquid nutritional supplements in the market use poor ingredients. Remember, you want to cure inflammation along with gaining weight, so avoid things like fillers of corn, vegetable oils, and artificial ingredients.

Use them as a supplement to your diet. They can be eaten between meals, when you don’t have time to eat a full meal, or as a replacement for solid foods to give your digestive system a break.

For so long, I didn’t move my body productively. Other than occasional short walks, exercise was not part of my lifestyle.

I was either too tired or worried that the exercise would burn calories that I couldn’t afford to lose. At that point, it didn’t occur to me that I should try to exercise with intention.

Strength training helps build muscle, which will benefit your body composition goals. In addition, it is important to maintain muscle mass, as a sedentary lifestyle and nutrient deficiencies put you at risk of loss.

I haven’t started strength training with weights, and I don’t recommend doing it if you’re recovering from a push or feel generally weak. Bodyweight exercises are a great place to start and include in your routine down the line.

Try anything from lunges, squats, push-ups, planks, and more. Start slowly and gradually increase your repetitions as you tolerate.

You don’t need a lot of time to do these exercises. Start your day with some of these exercises or take breaks during your workday and do a few repetitions.

This is a more drastic option that takes into account your health and vitality as a whole. You should consider the pros, cons, and the state of your health.

I list this as an option because having bowel resection surgery is what allowed me to take giant strides with my weight and overall health.

How does this work? A surgeon will remove the parts of your gut that have been scarred by the inflammation and possibly other areas that are very inflamed. Without these compromised areas, you can absorb nutrients much more easily and feel less pain.

For me, it was like having a clean slate. I have been able to gain weight and have maintained that weight for over 2 years in remission so far.

The surgery gave me other added benefits, like abundant energy and reduced symptoms.

Is Bowel Resection Surgery Right For You? This is a question you should take up with your doctor and discuss with a gastrointestinal surgeon. If you’re having trouble coming out of flare-ups, maintaining your weight, or dealing with the pain that interrupts your day-to-day life, your doctors may think this is a good option for you.

Keep in mind that every body and every case of IBD works differently. People gain and maintain weight in different capacities.

Gaining weight also takes time, especially when working with inflammation and pain. Be gentle with yourself and your journey, and reach out to your doctor and other healthcare professionals who can guide and support you through it.

The most important thing I want you to remember is that you are worthy of your own love no matter what you look like or feel.

Looking back, I can see how much I didn’t love myself back when I really needed it. Have an appreciation for the challenges your body faces and don’t lose sight of what you can accomplish.


Alexa Federico is an author, nutritional therapy practitioner and paleo autoimmune coach who lives in Boston. Her experience with Crohn’s disease inspired her to work with the IBD community. Alexa is an aspiring yogi who would live in a cozy cafe if she could! She is the guide in the MII Healthline app and I would love to meet you there. You can also connect with it on it website or Instagram.



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