The client sought support after experiencing unexpectedly rapid weight gain. They wanted help managing their weight but were concerned that the change did not seem fully explained by their usual eating habits or lifestyle. Nothing they did seemed to help.
Rather than assuming that the solution was simply to reduce calories, we completed a comprehensive assessment of the client’s medical history, symptoms, previous investigations and blood-test results.
The client had previously tested negative for coeliac disease. However, we identified that they had already been following a gluten-free diet at the time of testing. Because coeliac blood tests rely on the person regularly consuming gluten, the earlier result may have been falsely reassuring.
As the client was due to see their doctor, we prepared a letter outlining our concerns and requesting repeat coeliac disease testing. We also ensured the client understood how much gluten they needed to consume beforehand so the testing would be more reliable.
While awaiting further investigation, we developed practical strategies to support nutritious eating within their busy lifestyle. This gave the client useful changes to work on even if the coeliac investigation did not identify the cause.
At the client’s next appointment, they reported that further medical investigation had confirmed coeliac disease.
We then supported the client with more than simply identifying gluten-containing foods and preventing cross-contamination.
Their nutrition plan also focused on:
Although coeliac disease is traditionally associated with weight loss and being underweight, this is not how it always presents. Many people are diagnosed while above a healthy weight.
This case also demonstrates that weight management does not have one ideal pathway.
Some people benefit from a structured meal plan or a more specific energy target, while others achieve meaningful results by addressing an underlying health condition, improving dietary quality and establishing habits that better fit their lifestyle. For this client, treating the underlying issue and improving their overall nutrition was sufficient for the excess weight to come off without deliberate calorie restriction.
