Weight Loss With Irritable Bowel Syndrome  

Dr. Christopher McGowan
November 23, 2022

With nearly 15% of the population suffering from it annually, irritable bowel syndrome (IBS) is one of the most common digestive disorders in the United States and one of the most common reasons people visit a doctor of gastroenterology. IBS tends to be a chronic disease, and it has no cure, yet a number of treatments have been developed to ease the many symptoms and improve a patient’s quality of life. For those who are attempting to lose weight, however, some of these treatments may make that a little more difficult. Fortunately, though, doctors and nutritionists have identified ways to still achieve weight loss even with IBS.  

What Is Irritable Bowel Syndrome?        

Irritable bowel syndrome is a group of common gastrointestinal symptoms that present together in various combinations. Because of this, IBS isn’t a clearly defined condition and the symptoms will vary from person to person. The defining characteristic of these symptoms, though, is problems with the function of the bowels and maintaining consistency in bowel movements. The nature of these kinds of symptoms and their frequency can have a significant impact on a person’s quality of life and may disrupt work, school, or relationships. 

As noted above, irritable bowel syndrome is quite common in the U.S. and around the world, and many people may be suffering from it without even realizing it. Anyone can develop IBS, but women are twice as likely to have it as men. Also, unlike many other health conditions that affect us more often as we age, you’re much more likely to develop IBS before the age of 50 than after turning 50. IBS should not be confused with IBD (inflammatory bowel disease), a different condition that specifically involves inflammation of the intestinal lining.     

Symptoms Related to IBS

IBS is generally a chronic, life-long condition, yet the symptoms may change over time, especially if steps are taken to manage them. In general, the symptoms of IBS are related to bowel movements, so most people find that they lessen shortly after a bowel movement occurs. Below are some of the most common symptoms of irritable bowel syndrome: 

  • abdominal pain 
  • changes in bowel movements over time
  • diarrhea 
  • constipation 
  • bloating or cramping
  • feeling of having an incomplete bowel movement
  • pale-colored mucus in the stool
  • excessive gas or flatulence  

What Causes IBS?

The exact cause of IBS is unknown, but ongoing research suggests that it is likely a combination of factors. IBS is one of several types of functional gastrointestinal disorder, and these disorders are widely thought to be brought on by a problem with the interaction between the digestive system and the brain. This “gut-brain axis” involves complex biochemical signals between the central nervous system and the enteric nervous system. It is believed that disruptions to these interactions may be an underlying cause of IBS by increasing or decreasing the speed of normal bowel motility. 

While the cause of IBS is not fully understood, there do seem to be some common factors that might make it more likely for someone to develop it. There is also some evidence that genetics may play a role. Below are some of the factors that appear to be associated with IBS: 

  • food allergies, intolerances, or sensitivities 
  • bacterial infections of the digestive tract 
  • small intestinal bacterial overgrowth (SIBO), a gut health problem that stems from a change in the makeup of the gut microbiome
  • stress or traumatic events from early life like sexual abuse or physical abuse 
  • mental disorders like depression or anxiety  

How Does IBS Impact Weight Loss?   

On the surface, it may not be obvious why or how IBS could interfere with a weight management program or even cause weight gain. One reason is related to the impact IBS can have on quality of life; symptoms like diarrhea, constipation, and flatulence, for example, can cause significant anxiety in different kinds of social situations. The combination of ongoing physical discomfort and worry about gastrointestinal distress can cause depression and lead to overeating or eating higher-calorie comfort foods in order to feel better. Emotionally eating in this way can then further exacerbate IBS symptoms, causing a mental health spiral. 

Another reason it can potentially disrupt weight loss is because of the dietary modifications that are often necessary for patients with IBS. Since there is no cure for IBS, one of the ways to manage symptoms is by modifying your eating habits in order to avoid “trigger” foods. One of the most common strategies for this is to adopt a low FODMAP diet. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, and it refers to short chain carbohydrates that are poorly absorbed in the small intestine and instead are fermented in the colon. This fermentation process can cause gastrointestinal symptoms in some people, especially those with IBS. 

The American College of Gastroenterology has provided a list of some high FODMAP foods to avoid and some low FODMAP foods that are better for IBS. There are many foods on the FODMAP list that are otherwise very healthy options for any diet, including a diet that is geared toward weight loss. In eliminating those foods in an effort to manage IBS symptoms, however, it is easy to get in the habit of replacing them with foods that are high in simple carbohydrates. While such foods may not inherently be incompatible with a weight loss plan, high carbohydrate options tend to be less filling and are easier to metabolize; over time, this can promote overeating and inhibit a caloric deficit

How to Lose Weight With IBS

Even though it can be more difficult to lose weight with irritable bowel syndrome, that doesn’t mean it’s a lost cause. IBS symptoms can still be effectively managed at the same time as maintaining a diet that is both healthy and helps create a caloric deficit. The key is to find the right combination of foods that avoid IBS flare-ups, provide proper nutrition, and are enjoyable to eat. Below are some dieting tips for losing weight with IBS: 

  • Low FODMAP: As noted earlier, FODMAP foods have been found to be some of the most likely to trigger IBS symptoms. Limiting or eliminating these foods and replacing them with low FODMAP options is the first step.  
  • High protein: Emphasizing lean proteins is important for weight loss and general health and wellbeing. Protein is easier on the bowels than many carbohydrates, and it will leave you feeling full for longer. 
  • Healthy fats: Avoid trans fats and saturated fats and instead look to olive oil, seeds, nuts, and fish that contain omega-3 fatty acids
  • Avoid simple carbs: Foods that are high in sugar or refined carbohydrates like white bread, pasta, and cakes can trigger IBS symptoms while also negatively affecting the body’s insulin levels. 
  • Avoid sweeteners: Artificial sweeteners like sorbitol contain sugar alcohols (polyols) that are difficult to digest. 
  • Stay hydrated: Many people with IBS have a version that either tends to cause diarrhea or tends to cause constipation; in both cases, drinking plenty of water can reduce the chances of triggering either symptom.    

Bottom Line 

The bottom line is that it is definitely possible to lose weight with IBS, but there are unfortunately no quick and easy solutions. It is quite common for IBS patients to have to go through a period of trial and error to figure out what foods trigger symptoms and what foods are OK. The answer will be slightly different for each person, but the ultimate goal is to build a diet plan that meets the needs of IBS management while also providing proper nutrition; by emphasizing high protein and avoiding simple carbohydrates, you’ll be much more likely to experience regular satiety and avoid the cravings that often accompany a carb-heavy diet. 

Losing weight can be challenging if you have IBS or even if you don’t. If you’ve been trying to lose weight without finding success, it may be time for a new approach. At True You Weight Loss, we provide several different approaches to weight loss that fit different needs and different circumstances. If you’d like to learn more about our non-surgical weight loss procedures or weight loss medication options, please contact us today to request a consultation. We are passionate about helping you find the freedom you’ve been looking for!

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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