Does Constipation Cause Weight Gain and Bloating?
Yes Constipation can cause Weight Gain. And here is how and why.
There are two key factors for how constipation can play a significant role in weight gain. One is gut bacteria, and the other is related to water retention. You might be experiencing rapid and fluctuating weight changes (going from feeling light one day, to 1-2 pounds heavier the next). You’re probably careful with your diet, yet you’re gaining weight no matter what you eat. You might lose a pound or two, only to put it back on over night. Does this sound like you?
You likely feel frustrated and panicked at this point, and don’t know what to do. Despite doing everything you’ve read you should do, you feel more heavy, bloated, puffy and sluggish.
In fact, this scenario is such a common complaint for us in our Nutritionist and Functional Medicine clinic, that we’ve specialised in this area, and has undertaken a lot of research and dedicated a lot of time to helping our clients recover their natural weight, and resolve their constipation..
So can constipation actually make you put on weight, and how much weight can constipation add? In this article we want to get you help for your constipation by sharing some of the science, our clinical insights and some practical tips to help you get back on track with your weight goals.
Jump To:
Bloating - a consequence of constipation
Water retention: the body’s fight for gut movement?
Gut bacteria and constipation and weight gain
The Best diet for weight gain triggered by constipation
The best supplements for constipation related weight gain
Is it SIBO? When to SIBO test and when not to
Thyroid: when it is and when it isn’t a problem, and how to rebalance naturally
Bloating - a consequence of constipation
Let’s clarify first what bloating means. When people talk about bloating, they usually mean one of two things:
an extended tummy, or
water retention: a feeling of puffyness or increased weight, swollen fingers or ‘belly fat’ or swollen ankles. The term tends to be used interchangeably by our clients, and both often occur together
They’re two separate things but of course can occur at the same time, as they typically do in constipation.
An extended tummy
When constipated, you’re always going to have the feeling that your tummy is swollen and extended, due to the fullness of the intestines holding your stool/faeces. When the intestines aren’t eliminating what you’ve eaten, bacteria in the gut will be effected, which tends to also cause wind, which often gets trapped due to the blocked gut, leading to even more bloating and sometimes a ‘pregnant’ look. This can also cause a sharp, lower tummy pain, and can feel worse in the evenings and better in the mornings, but for some people the feeling is the other way around. You might feel heavy, sluggish, and extremely uncomfortable (not to mention frustrated).
Water retention, puffyness
Water retention relates to how your body hold onto water. This can change when a person is constipated, and you might feel this comes and goes, sometimes almost over night. Taking over the counter diuretics to clear the water retention at this stage would not be the answer in our opinion, as you need to be well hydrated to combat constipation. In fact, constipated people need to absolutely be well hydrated, by water only and ideally drunk in between meals for most of it (to aid digestion).
Water retention, the body’s fight for gut movement?
You might notice deep indentations on your skin from socks, trousers or on your cheek in the mornings. Your rings might feel tight, and this might come and go.
What causes it? The phenomenon cannot be explained scientifically, but from experience we know that many people experience water retention when they constipated. At times, it can come and go very quickly and ease off after laxatives or a complete bowel movement, indicating a link with not being able to eliminate.
Water and body fluids are involved in gut transit and digestion. Effective water transport and normal hydration state of the gut mucosa (mucous lining in the gut lining) are necessary for a protective gut barrier to function effectively. In fact, a huge amount of liquids are involved in the digestion, and we produce many litres a DAY of digestive juices (which are reabsorbed by the body). When gut transit is slow, our stool tends to continue to dry out, slowing down gut transit further. In fact, many laxatives you’ll receive from your GP will be ‘osmotic’, bringing water back into the intestines, to move the stool out.
With water retention in constipation, it’s almost as if the body doesn’t want to let go of water - perhaps in an attempt to help the stool move out? However, it’s very possible that it’s rather to do with constipation simply interfering with the body’s ability to balance its normal fluid levels, or food intolerances that can go hand in hand with constipation and SIBO. Either way, it adds to the uncomfortable feeling, and can add a feeling of weight gain and general unwell-ness.
Causes & Treatment of Weight Gain from constipation
Constipation and weight gain - what’s the connection
Constipation & Microbiome Stool Test
An imbalance in gut bacteria is a huge driver in constipation, in particular in very stubborn long-standing constipation, and constipation that doesn’t improve with an improvement in diet. Of course microbes are invisible and not tested for in traditional medicine, and so you may have been told by your GP that ‘all is well’ and to simply take laxatives (which don’t tend to work very well). We have to look deeper however for the answers. As well as gut bacteria/microbes (candida, parasites, bacteria) causing you to be constipated, it’s also negatively impacted by stool (poo) sitting in the intestine for too long, and can thereby create a bit of a vicious cycle.
How Does Gut Bacteria cause weight gain?
We’ve known for a while that gut bacteria can change how we absorb calories. The mechanisms explored relates to a variety of different bacteria, and we don’t have the full picture by far. In fact, in faecal transplant cases (when people get implanted someone else’s gut bacteria to help with severe gut disorders), they’ve measured what happened to weight in a relatively large human study of 328 people. Whilst 65% remained the same weight, others lost (12%) weight, and 20% gained two weight groups. In another interesting case as reported by the BBC, A woman has dramatically gained weight after a stool transplant from her daughter. However in all these cases, there’s another potential reason these people gained weight after their transplant, and this is that they had severe gut dysfunction previously, and after the transplant could potentially digest their food and calories better. However, this still does not fully explain the picture where a person and family has never experienced obesity in the past.
So we know that gut bacteria matters when it comes to your weight, and we know that a healthy and balanced gut bacteria/microbe population is best.
Gut bacteria and constipation and weight gain
Skip over if you’re not interested in the technical bit.
Gut Bacteria Balance: The Firmicute / Bacteriodetes (F/B Ratio) Balance
It’s been proposed that when the gut bacterial families (‘phyla’) Firmicutes and Bacteroidetes (F/B) ratio is out of balance, we tip the balance towards more weight gain from the food that we eat. There’s a ton of research to suggest this to be true, however in our clinic where we’ve both tested the stool of hundreds of people and simultaneously have great detail of the persons diet and full case history, we’ve not found this to always be true. There are other factors that can still be more important than this balance, such as type of diet and lifestyle, and it’s our job as Nutritional Therapists to connect all the dots for our clients, mapping out the root cause for the individual.
Some of the research on this if you’re science-minded:
The Microbiome guide to weight gain article
Short-chain fatty acids (SCFA) such as butyrate contributing to obesity
SCFA’s are molecules made by gut bacteria. When we talk about gut bacteria being beneficial to us, our weight, mental health and general wellbeing, this is what we usually mean (as well as the vitamins produced by the gut bacteria for us. Very generous :)).
Many studies have showed how a healthy balanced gut bacteria produce more of these fantastic molecules, that we know benefit our metabolism, appetite and weight. Our bodies produce these SCFA when we eat wholefoods and foods with plenty of fibre, such as vegetables, roots and plants.
Gut Bacteria in constipation and weight gain - The Treatment
For a re-balancing of gut bacteria there are two major options:
1) Altering the diet (see below for specifics). Note that if you experience severe gut issues this may not be enough, and in fact could make your symptoms worse. If you’re not sure, drop us a line and and we’ll be happy to give you some direction.
2) Natural treatments with supplements and remedies (see more detail below)
3) A bespoke program to re-balance your gut bacteria, with herbs, supplements and natural remedies.
The Best diet for weight gain triggered by constipation
Fibre
The general diet for both constipation and weight gain would be very generous portions of vegetables and plants. Many of us tend to add more grains when they want more fibre, but we would recommend vegetables instead. Don’t forget about the more ‘meaty’, filling vegetables, such as aubergine, sweetcorn and peas. These are great alternatives to both meat and grains, and in fact are amazing low calorie foods. Lentils and beans are also unbeatable. IF you find that these foods make you feel worse. I.e you feel more bloated, gain more weight or feel inflamed - get in touch as this could mean that you have an imbalance in your gut bacteria that firsts needs a bit of a treatment.
A caveat - who should NOT add more fiber?
Whilst fibre is generally recommended for constipation, in fact, many constipation cases will not do well with more bulk, which simply add’s more to the ‘car jam’. We’d recommend clearing out the constipation first, and trialling just adding a couple of carrots a day at first, to see whether the effect is negative or positive. If you experience a lot of wind or tummy pain, any increase in fibre, whether plant sources or not, are likely to worsen symptoms. If your problems are not severe, the additional wind symptoms will subside over a few weeks, but if your symptoms are severe and you have SIBO or bacterial imbalance (dysbiosis), your symptoms could worsen and worsen the longer you eat more fibre. Again if this happens to you just drop us a line and we’ll help give you some direction of what you should do.
What Supplement for constipation: Nutritionist Inside Tips
Supplements to get your gut moving can help you immediately feel lighter and less bloated. Whilst we cannot give personalised supplement recommendations without a case history, we use the following two products with many of our clients as an effective and quick way to end constipation. Note that it doesn’t heal the root cause, and you must ensure that any supplement is the right thing and safe for you to take (check medication contraindications and other health issues - and never take for more than 4 weeks without first checking with a professional):
Magnesium Citrate 120mg x 2-3 at night - Discount Code: LAG15 (15% off). Note that some people find that taking it 3 times a week works better for them than taking it every night, so try both methods
Ripe Papaya (make sure it’s ripe. Circa half a small one a day). OR, what most people prefer is an easier format that you can also carry with you, and it also really helps digestion overall: Papaya sticks - Discount Code: LAG15 (15% off)
If your constipation is very stubborn or severe - you can take two of the above, or even all three. Again, because this is generic advise and we haven’t made this recommendation based on your personal case detail you just need to assure yourself that you use supplements safely. If you have any queries about these supplements and how to take, feel free to drop us a line here.
Feeling Confused? Drop us a line with details of your current intake of fibre, constipation or wind problem and we’ll give you a free assessment.
SIBO: when to SIBO test and when not to
SIBO TEST SAMPLE. ASK US A QUESTION ABOUT SIBO TESTS
You may have come across SIBO in your research and established that this can be a trigger for constipation as well as weight gain. SIBO is always a consideration in stubborn constipation that responds poorly to an improvement in diet, and can in some cases explain weight gain.
Should you always test for SIBO if you have constipation?
Not necessarily. Whilst it can be super relevant and in an ideal world we’d do all the testing needed for everyone that walks through our door, but financially this doesn’t always make best sense. Let us explain why.
The Symptoms of SIBO
First let’s establish the likelihood of SIBO being the culprit. The symptoms of SIBO can be quite distinct, but also confusing and stressful for the client, due to their obscure nature.
The symptoms you might experience are severe bloating after food (however this alone can have many causes), histamine issues, acid reflux, joint pain, fibromyalgia, low mood, fatigue and food intolerances SIBO is truly one of the most disruptive digestive concern you may have, and it affects many many people. You may have just one symptoms - or if you’re unlucky, all of them.
What SIBO is and what it isn’t
SIBO isn’t actually truly a ‘condition’, but rather a sign of general gut dysfunction and gut bacteria imbalance. SIBO rarely occur of it’s on, and there’s usually something else in the digestive system not in balance. In fact in research, SIBO use to be considered simply a symptom of something else and to treat SIBO you should simply fix the root problem. Whilst we know the picture to be slightly more complex now, this remains largely accurate.
Therefore, to properly treat SIBO, we need to look at your whole digestive system for the triggers of this extremely disruptive symptom. In other words, we want to understand what caused SIBO to treat SIBO. This prevents it from simply returning after it’s been addressed.
Post-infectious IBS: Experiencing IBS after food poisoning or a gut infection
Never fully recovering after a bout of food poisoning or a gut infection (vomiting/diarrhoea) when abroad is relatively common. We call this post-infectious IBS. We believe this to be partly due to SIBO, which makes sense when you understand the mechanism of the gut, the gut bacteria and a gut infection.
Often in these cases however, there may have been a gut imbalance brewing in the background even before this happened, leaving you more susceptible. We inherit gut microbes from our mother, so it’s possible to have a slightly weakened microbiome right from the start! Does your mother eperience gut symptoms or any of the above SIBO symptoms perhaps?
Other SIBO causes are sluggish bile flow, the long term constipation itself, taking omeprazole and other medication for acid reflux, or low stomach in general due to nutrient deficiencies or levothyroxine medication.
When to test and when not to
SIBO testing will look only at whether there is SIBO or not. However, you may have SIBO as well as dysbiosis in the colon, low stomach acid and malabsorption for examples. Therefore, what we don’t want to do is test for SIBO and miss other important triggers both for your symptoms and for the SIBO cause. What we don’t want is to treat the SIBO and for it to come back 6months later, which will happen if we don’t treat the cause of your SIBO! You’ve likely at this point invested lots of money and hard work. You want to ensure you keep your gains.
So our point is that SIBO test can sometimes give too small of a picture and in fact an Advanced stool analysis instead, would give your practitioner a much more comprehensive picture of your entire digestive health and processes. Ideally of course, bother together is the optimal test package in severe gut issues. Because SIBO can indicate that there is imbalance in the gut overall, zooming in too much and only on this part of the small intestine doesn’t provide enough answers.
Which gut health tests should you buy for constipation and weight gain?
Our Nutritionist recommendations are:
Option 1.: The Mini Gut Microbes (with pathogens/candida/parasites) test + SIBO test
Option 2: The Maxi Advanced Gut Test is a comprehensive stool analysis with over 100 markers + histamine if you have joint pain, allergies or acid reflux
Option 3: Gluten intolerance, if you’re suspecting a problem with gluten but coeliac blood tests have been negative. Gluten intolerance may cause really persistent constipation, however note that SIBO tends to make you intolerance to ‘di-saccharides’ (grains, dairy, sugar) so in the majority of cases by far, an intolerance to gluten is rooted in a SIBO or even gut dysbiosis (imbalance in colon bacteria) not a gluten intolerance. Get in touch if you’re not sure.
To conclude, a SIBO test isn’t always the best use of your money, and you may be left with only partial answers. There are some cases where SIBO is absolutely a justified test, such as when someone experiences lots of body-wide unexplained symptoms, and to re-test and monitor after treatment. Ideally however, in these cases we would also do a stool test.
A word on the cost of functional tests
I wanted to add some comments here on this, as it’s something close to my heart. Tests aren’t cheap (but hopefully as tech progresses these tests will be in the future!), and as a practitioner I don’t just recommend these tests, I also rely on functional tests for myself and for my family. So i’m fully aware of the financial investment and the worries around spending money on your healthcare (it’s meant to be free right?).
In my own health journey, i would never have been able to solve (and manage) my own health conditions without the use of a lot of tests. It’s been expensive, but not optional. Sometimes, you may not even get all the answers from just one test and you need to continue the investigations, and that’s ok.
I know we want our doctors to ‘fix’ us and that we expect to receive our healthcare for free - and it stings having to fork out for something other than ‘fun things’.. But in these modern conditions, traditional medicine simply can’t offer a lot of resolutions, and I think we have to accept this. This is new science and new health problems caused by a change in our lifestyles and even healthcare.
Women often feel guilty when spending money on their own health, or feel that it’s somehow wasteful. In fact, it’s an ‘oxygen mask’ first scenario, and what could be more important than how you go through your life (dragging your feet - or feeling great?). Could in fact your health be THE most important thing in your life,, both for yourself, in being there for your children and in being a happy wife? Women - if you’re struggling with health issues that impact your life. Please know that your wellbeing is important. How you feel matters. And perhaps feeling good from the inside is even more important than having your nails done, or a new pair of jeans.
Apologies for the slight digression but we are on a mission to change people’s mindset. As women and as humans, we deserve to have health - or at least the best we can.
is Thyroid the cause of your constipation?
You may be experiencing:
Wondering if your thyroid is an issue even though your GP said your bloods are fine
You take levothyroxine, but still experience many of the thyroid symptoms, such as constipation and hair loss
Thyroid issues or medication can cause very stubborn constipation, but what’s important is to support the body’s production of the hormones, or in the case of medication - the conversion of the hormones to T3, which can be done with diet and supplements.
You need a number of important nutrients for the thyroid to operate optimally, but if you’re under a lot of stress or have been ill, expect that bloods may show a temporary imbalance or deficiency. This is normal.
What to eat to improve your constipation caused by thyroid or thyroid medication
You need the following nutrients to ensure your thyroid has the opportunity to operate optimally:
enough protein in the diet! You require circa 50g a day. Request a protein schedule from us Here if you need
selenium (brazil nuts x 1 a day)
sufficient iron (optimal levels, not lower end of ferritin on blood tests)
iodine. If these are in short supply, you might not convert T4 to T3 as well, or might be low in hormones overall.
Enough Zinc is critical, and many people don’t get enough from their diet, despite eating plenty of meat, fish and seeds (soak before eating). Grains are not good sources unless previously soaked (which of course we don’t tend to do). If you take levothyroxine you may need to supplement as it may inhibit absorption and thereby effectiveness of T4 to T3 conversion.
A balanced gut microbiome! Gut microbes plays an important role in the processing of of thyroid hormones and is thought to impact thyroid autoimmune diseases. In addition, the healthy byproducts naturally produced by our good bacteria (sometimes termed post biotic) and even bile products, are thought to impact the functioning of the thyroid gland. We will write more on this in a future article.
Taking thyroxine medication or a hypothyroid condition often worsens constipation, but we would still recommend considering the microbiome the nutrients above.
The other major cause of unexplained weight gain
We won’t go into this big topic in this article, but the health and status of your insulin and blood sugar is a huge factor (and the most common I would say) in weight gain that keeps on creeping’, and you can read more about this topic here:
Why i recommend everyone tracks their glucose for two weeks, and watch their health issues melt away
Get Unstuck With Your Weight Loss in Just a Few Guided Steps
Learn why you can't lose weight, despite fasting, Zoe or keto
A Success Story S.B, Female Aged 32 with chronic constipation, sugar cravings, on/off ‘puffyness’ and low mood
The client came to us with very severe constipation for most of her life. Fibre made her constipation worse, and at her worst felt like she ‘never’ went to the toilet unaided. Sugar cravings started in childhood but were now described as an ‘addiction’. She felt extremely heavy, bloated and frustrated and could not seem to loose weight. She had a history of antibiotic courses in her life spread out from childhood, teens (a few ear infections), removal of wisdom teeth, and the odd UTI and other infections. She could correlate back her constipation starting around the time of the ear infections and antibiotic courses, and her diet at that time was not great, and no probiotics were taken to help the microbiome recover in a healthy way post antibiotics.
A microbiome analysis revealed klebsiella and candida albican (a fungal microbe) overgrowth, which wasn’t a surprise given the sugar cravings. Candida can be very constipating, so these was addressed first, with a sugar free and white flour free diet for 8 weeks, together with the natural remedies allimed (4 a day), biocidin drops which we had to stop as they worsened the constipation too much, and a mixed supplement aimed at SIBO. Klebsiella can be rather inflammatory, and tend to worsen with a high starch/grain diet, so we switched her carbohydrates to other sources. We also removed dairy as there was some indication in the stool test that there might be SIBO, a common consequence of very severe constipation.
We then added a prebiotic: PHGG (discount code: LAG15) which we started her on in a very low dose. The ultimate aim of all gut programs is to improve the microbiome, properly addressing root cause of any gut issues and ensuring they don’t return (this however is not usually step 1). PHGG can help gut movement, but most people have to start on a VERY small dose. If you go too quick, it may cause more constipation, so play around with the dose and be patient. At this point, the client had small movements every day, and was very pleased - but the ultimate aim was complete resolution. We put her back for a second round of allimed (Discount code: LAG15, but we always recommend taking with professional supervision). This initially caused some constipation, but we persevered using mild herbal laxatives to manage symptoms in the meantime. At 8weeks, she had a major breakthrough, and started having complete (100%) bowel movements daily. She could also tolerate more dietary fibre which brought her great joy, as she could eat more healthy foods (thereby promoting a healthy microbiome).
Conclusion
Addressing weight gain with constipation requires a gut microbe balancing approach. From understanding the triggers to the right supplements and tests, we connect the dots to work out what’s going on for you specifically. You may have struggled to work out how to resolve your health concerns because you’ve followed generic advice, but unfortunately, no two people with constipation and weight have, have the exact same causes!
Tests can be super useful in understanding the problem and creating your health plan roadmap, whilst we understand that they can be expensive. We’re here to install some hope, and to help support you with whatever queries you may have.
How we could help your constipation and weight gain
Want to know if you should SIBO test, or if there’s a better way for you? Want to know what might be the likely best method for your poor gut health?
What to do next: Book a quick call to get access to your Free Weight Gain and Constipation Assessment, and we’ll let you know whether we think constipation is what’s causing the weight gain for you, and what steps you need to take.
