Constipation is a common gastrointestinal problem that affects virtually every person at some point in their life. While not typically a very serious condition, there’s no doubt that constipation can be unpleasant and cause disruptions to a person’s normal quality of life. What many people don’t realize is that constipation by its very nature can contribute to weight gain. The good news is that treating constipation can reverse some of that weight gain and even have a positive impact on overall health and wellbeing.  

What is Constipation?   

In simplest terms, constipation is the condition of having infrequent or hard-to-pass bowel movements. Even though every person is different, the “normal” standard for bowel movement frequency is anywhere from 4-5 times per week to multiple times per day. By comparison, most doctors define constipation as having fewer than three bowel movements in a given week. And even when bowel movements do happen, they tend to involve stools that are particularly hard and dry. This may also be accompanied by the sensation known as tenesmus, the feeling of incomplete defecation.  

Rather than a disease or disorder itself, constipation is a core symptom of the digestive system that indicates another underlying problem or deficiency. Occasional acute constipation is fairly normal for most people, but it can also become a chronic or recurrent concern that lingers over many years. All people in all age ranges can and do get constipated, and it is estimated that millions of people every year suffer from chronic constipation. Yet it tends to be more common among adults 60 years and older; it is also a very common occurrence in nursing homes and assisted living facilities where elderly residents are not as mobile. 

What Causes Constipation?   

The basic mechanism of constipation can be understood as a malfunction of the normal digestion process. When the digestive tract is functioning properly, food that has been partially broken down in the stomach moves into the small intestine; during the passage through the small intestine, nutrients get actively absorbed into the bloodstream where they can be used by cells throughout the body. The mostly liquid chyme substance then moves into the large intestine for the last part of digestion and the formation of stool that is both firm and soft. 

Once in the large intestine (or colon), the remaining waste includes undigested food material, damaged cells, and a lot of water. One of the primary functions of the colon is to absorb water so the stool can become solid. The speed with which the material moves through the colon is called bowel motility. If it moves quickly through the colon, too little water will be absorbed and the outcome will be loose, watery stool (diarrhea). If it moves slowly through the colon, too much water will be absorbed and the outcome will be hard and dry stool: constipation. 

So, in a sense, the “cause” of constipation can be anything that leads to a decrease in bowel motility. There are a wide variety of possible causes that can fit this definition, and many are related to dietary and lifestyle choices that can be modified in order to reduce the likelihood of constipation. Below are some of the common causes and risk factors that doctors have been able to identify over time: 

• Dietary fiber: The amount of dietary fiber you consume in your daily life is a crucial element of overall digestive health and the development of constipation. In terms of bowel motility, fiber can add substance and bulk to stool as well as making it softer and easier to pass by absorbing more water. If you lack sufficient fiber in your diet, you’ll be much more likely to have regular hard and dry stool.
• Water consumption: In a nutshell, drinking too little water is bad for bowel motility because there’s simply less water for the colon to absorb; but since the colon absorbs the same amount of water anyway, less in the colon means an end result of drier and harder-to-pass stools. Conversely, drinking sufficient amounts of water can essentially lubricate the bowels and improve motility. 
• Physical activity: Many people don’t realize that exercise and other forms of physical activity are helpful for bowel motility; this is primarily because physical activity literally helps stool move more quickly through the colon. That, of course, means that less water is absorbed and more is retained in a softer stool. Lack of exercise, or an otherwise sedentary lifestyle, is therefore much more likely to lead to constipation.  
• Life circumstances: Sometimes even minor disruptions to the habits of our daily life can also disrupt our bowel movements. Travel, new foods, or stress can all temporarily change how our bowels operate, and in some cases constipation is a result (as well as diarrhea).  
• Resisting the urge: There are times when the “urge” to go doesn’t match up with having access to facilities or time to go. In these cases, resisting the urge can cause stool to stay sitting in the sigmoid colon for too long. As it sits there, water continues to be absorbed, and all the while the stool becomes harder and drier.  
• Medication: Numerous medications designed for other purposes sometimes include constipation as a side effect. Examples include medications to treat seizures, antacids that contain calcium, or iron supplements. 

How Does Constipation Cause Weight Gain?  

In recent decades, new research has helped doctors understand that there is a strong link between “gut health” and overall health. In addition to being the last stage of the digestive process, the colon is the site of a thriving microbiome of gut bacteria that are beneficial to us and perform many important functions. One of those functions, as researchers are now learning, is to help stabilize and normalize bowel function. There is also now evidence that specific bacteria in the microbiome may be causing weight gain by further extracting nutrients (and thus calories) from waste material in the colon. 

More research needs to be done to fully determine the possible impact of these gut bacteria, but it is clear that the composition of the microbiome affects many aspects of digestion and bowel movements. Regardless of the underlying microbial balance, there are several other possible connections between constipation and weight gain: 

• Water retention: In general, any kind of water retention or bloating will tend to keep water elsewhere in the body instead of in the colon. This can naturally lead to both constipation and overall higher body weight. 
• Thyroid: One of the main functions of the thyroid gland is to regulate metabolism. In people with hypothyroidism, the thyroid doesn’t make enough thyroid hormone; as a result, less energy is used for the body to function and more of it is stored as body fat deposits. This also leads to slower bowel motility and constipation, which, in turn, can cause more weight gain. 
• SIBO: Short for small intestine bacterial overgrowth, SIBO is an example of bacterial overgrowth in the intestines that usually stems from constipation and creates many factors that contribute to weight gain.  

Preventing Constipation         

It’s important to note that simply resolving constipation won’t necessarily lead to dramatic weight loss. Losing weight is a complex process that requires a number of lifestyle changes for long-term success. Yet there’s no question that constipation is connected to both weight gain and imbalances in the microbiome. To prevent constipation, and to avoid any associated weight gain, the following tips will be helpful: 

• eat more foods that are high in fiber (like whole grains)
• drink plenty of water and other fluids 
• get regular physical activity, even if it means starting slow and small 
• if adding fiber to your diet is challenging at first, fiber supplements can help 
• for acute bouts of constipation, laxatives can be beneficial; however, make sure to not overuse them as your bowels can become dependent on them

Alternative Weight Loss Solutions

A poor diet can lead to constipation or any number of other medical conditions, but true weight loss usually involves more. At True You Weight Loss, our team is passionate about helping people find the right combination of treatments and changes that can turn your life around and give you the freedom you’ve been looking for. If you’d like to learn more about our non-surgical weight loss solutions, please contact us to request a consultation. We are eager to talk with you and find a unique solution for your circumstances.