How to Gain Weight When You Have IBD

Being underweight can be a significant problem for people with inflammatory bowel disease (IBD). Many of the signs and symptoms of IBD (Crohn's disease and ulcerative colitis) can lead to significant weight loss. In our society, being thin is often seen as desirable or a sign of good health, but, in fact, for people with chronic illness, being too thin can be a problem.

For people with IBD who are already very thin, experiencing a significant flare-up could lead to further unexpected weight loss. In children and teens, taking in a healthy number of calories (including an appropriate amount of the right kinds of fat) is important, and necessary for growth.

Being too thin can also contribute to a weakened immune system, anemia, hair loss, and infertility.

Gaining a few pounds might be in order for some with IBD, but how to do it in a healthful way? Eating fatty or high caloric foods and not exercising may result in weight gain, but they are not optimal for maintaining future good health. For those in remission, here are some tips on how to gain weight for people who have IBD.

1

Eat More

A plate of garnished hummus on table surrounded by various salads
Vladimir Godnik / Getty Images

Probably easier said than done, but in order to gain weight, a person needs to eat more calories than they expend on a daily basis. This can be a significant challenge in cases where diet is already extremely limited, so the focus needs to be on healthful foods that can be tolerated.

Underlying nausea or diarrhea from IBD may need to be first addressed in order to be able to eat larger quantities of food.

2

Eat High Nutrient Foods

poached Egg with Whole Grain grilled Bread and Sliced Avocado
DronG / Getty Images

If you have IBD, you already know that processed convenience foods are not going to be the best choice for your diet. A better choice ​is foods that have a lot of nutrients in a smaller package.

Foods that are considered nutrient-dense would be fruits and vegetables, beans, whole grains, dairy products, heart-healthy fats (e.g. avocados, fish, olive oil) and nuts and seeds.

For those with IBD who find these specific foods problematic, other low-fiber choices include peanut butter, eggs, oatmeal, bananas, salmon, and tofu. The more "whole" your foods are, the more nutrient-dense your diet will be.

3

Juices and Smoothies

Freshly blended fruit smoothies of various colors and tastes
The Picture Pantry / Getty Images

For those with nausea or a low appetite, smoothies and juices can be a great way to add extra calories and nutrients to the diet. The possibilities for smoothies are endless: they can include almost anything you can think of, and appeal to any palate. Smoothies may be especially helpful for those who have problems chewing and swallowing, such as those who have a condition that affects the mouth or the esophagus.

4

Eat More Frequently

Bento Box
masahiro Makino / Getty Images

Many people with IBD can feel full after even a small meal. What may help with feeling full after only eating a little is to eat smaller meals, but to have them more frequently. Eating 5 or 6 smaller meals a day instead of 3 large ones could help avoid that uncomfortably full feeling.

Eating more often may create the overall effect of constant eating, but it can help get more calories into the body.

5

Add a Topping

Raw Organic Avocado Hummus
bhofack2 / Getty Images

An easy way to add more calories to a meal is to add a topping or even a dip. Adding some cheese (dairy if you can tolerate it, or non-dairy if you can't) to the top of your vegetables or eating them with some avocado or hummus dip can add something extra to your meals and snacks. Peanut butter (or sunflower butter, almond butter, or soy nut butter) or yogurt can be a nice compliment to fruit, and cream cheese (both dairy and non-dairy versions) goes well with some celery or a bagel.

Do What's Right For You

Diet is extremely individualized with IBD. It's probably the most divisive and hotly debated topic amongst those who have IBD.

Avoiding your particular trigger foods is important, but this must be balanced with eating a healthful diet and maintaining an appropriate weight for your body. The goal should be to eat as well as possible to get the most out of your food, given the challenges that IBD brings.

If you are struggling with gaining or maintaining weight with IBD, consult your primary care provider or registered dietitian. They can help you create a plan that works best for you.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Dong J, Chen Y, Tang Y, et al. Body Mass Index Is Associated with Inflammatory Bowel Disease: A Systematic Review and Meta-AnalysisPLoS One. 2015;10(12):e0144872. doi:10.1371/journal.pone.0144872

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Ulcerative Colitis.

  3. American Academy of Family Physicians. Changing Your Diet: Choosing Nutrient-rich Foods.

  4. Canadian Society of Intestinal Research. Dysphagia Overview.

  5. Lewis JD. The Role of Diet in Inflammatory Bowel DiseaseGastroenterol Hepatol (N Y). 2016;12(1):51–53.

Amber J. Tresca

By Amber J. Tresca
Tresca is a freelance writer and speaker who covers digestive conditions, including IBD. She was diagnosed with ulcerative colitis at age 16.