Gaining weight ulcerative colitis: 10 practical tips

If you're losing weight or struggling to keep it on with UC, you're not alone. Here's a calm, clear plan to safely add calories, prioritize protein, and work with your care teamwithout worsening symptoms.

Below you'll find people-first tips that actually fit UC life: gentle, high-calorie foods, protein strategies, flare-friendly tweaks, light movement, and when to ask your doctor or dietitian for more help.

Why it matters

Can you gain weight with UCand is it safe?

Short answer: yes, you can gain weight with ulcerative colitisand doing so can be not only safe, but genuinely helpful when you've lost weight during flares or after long bouts of poor appetite. The key is a gentle, strategic approach. Think of it like rebuilding a house after a storm: you don't rush the foundation.

What causes UC weight loss vs. weight gain?

UC can tug your weight in both directions, often at different times. During flares, appetite can tank, diarrhea can reduce nutrient absorption, and fatigue makes cooking or eating feel like a marathon. That's a perfect recipe for unintentional weight loss. On the flip side, when inflammation comes under control, appetite may come roaring back, and certain medicationsespecially steroidscan push weight up quickly.

Medications and their role in weight changes

Steroids like prednisone are notorious for increasing appetite and promoting fluid retention and fat gain. Some biologics, by calming inflammation, can indirectly lead to weight gain because your body finally absorbs nutrients again and you feel well enough to eat. It's a double-edged sword: helpful for healing, but it requires mindful eating so the gain favors muscle over central fat. According to reporting from Medical News Today, steroid-related changes and appetite shifts can be significant, which is why a plan matters.

Appetite, malabsorption, diarrhea, fatigue, and exercise barriers

When the gut is inflamed, digestion speeds up and the lining can't absorb nutrients as well. Frequent trips to the bathroom and cramping make eating less appealing. Fatigue turns meal prep into a chore. And when you don't feel well, exercise often takes a back seatso the weight that does return may skew toward fat rather than muscle unless you intentionally include gentle movement and protein.

Is gaining weight with UC beneficial or risky?

Benefits vs. risks

Benefits of regaining weight after a flare include stronger immunity, better energy, improved mood, and restoring lean body mass. The risks? Rapid gain that's mostly fatespecially around the abdomencan worsen insulin resistance, joint stress, and overall health. Slow and steady wins here: think muscle-first gain through protein and light resistance training, with calories that your gut actually tolerates.

What the MOSAIK cohort suggests

Real-world data can offer clues. In the MOSAIK cohort published in BMC Gastroenterology (2023), patients with IBD who gained weight after treatment showed diverse outcomes. The take-home: weight changes after therapy often reflect disease control and nutritional recovery, but the pattern of gain matters. Gaining lean mass is generally favorable; rapid central adiposity is not. Translation: aim for gradual, quality weight gain.

Red flags: when to call your doctor

Reach out to your GI team if you notice persistent bloating with severe pain, sudden or unexplained rapid weight gain or loss, signs of dehydration (very dark urine, dizziness, fast heartbeat), blood in stool that worsens, or steroid side effects like mood swings, high blood sugar, or swelling. If something feels off, trust that instinct.

Quick-start plan

Set a gentle target

Start with a small calorie bump: about 250400 extra calories per day. That usually supports roughly 0.250.5 lb (0.10.25 kg) of gain per week. It's enough to move the needle without stressing your digestive system. Adjust with your clinician if you're underweight or recovering from a significant flaresometimes a higher surplus makes sense, but only with supervision.

Track what you tolerate

For 714 days, keep a simple food-and-symptom diary. No need to obsessjust jot down what you ate, portion, timing, and how you felt afterward. Patterns show up fast: maybe nut butters are fine but whole nuts aren't; perhaps lactose-free yogurt sits better than milk; maybe raw salad is a no during a flare but steamed veggies are okay. This personal map is priceless for building your High calorie diet UC plan without landmines.

Build a flexible meal rhythm

Three meals and two snacks, or four mini-meals and one bigger dinnerpick what your gut tolerates. Smaller, more frequent eating often works best during active symptoms. In remission, you may handle larger portions. The goal is consistent fueling, not perfection.

Protein first

Protein for UC weight

If weight gain is the destination, protein is your GPS. Aim for roughly 1.21.6 grams per kilogram of body weight per day (talk with your clinician if you have kidney issues or other medical conditions). Protein supports muscle repair, immune health, and steadier weight gain.

Gentle protein ideas

- Eggs: scrambled, omelet, or frittata with soft veggies.

- Lactose-free Greek yogurt or skyr; or regular yogurt if you tolerate lactose.

- Smooth nut butters blended into shakes.

- Tender chicken or turkey, slow-cooked beef, or flaky fish.

- Tofu, tempeh, or silken tofu in soups and smoothies.

- Protein powders (whey isolate, pea, or rice) added to oatmeal or smoothieschoose low-FODMAP options if you're sensitive.

Protein timing

Spread protein across the day2035 grams per meal or snackrather than cramming it all at dinner. Your muscles can only use so much at once, and steady intake aids recovery and appetite.

Calorie boosters

High calorie diet UC

When appetite is iffy, pack calories into small volumes. Think creamy, smooth, and easy to digest. Here are GI-friendly add-ins you can stir, drizzle, or blend into what you already eat:

- Olive oil or avocado oil: a tablespoon adds ~120 calories with little volume.

- Lactose-free whole milk or fortified plant milks.

- Avocado, mashed or blended.

- Nut and seed butters (peanut, almond, tahini, sunflower).

- Oats soaked overnight in milk with a scoop of protein powder.

- White rice, rice noodles, or sourdough bread if you tolerate gluten; gluten-free bread if not.

- Bananas and canned peaches/pears (in juice), which are softer on the gut.

- Cottage cheese, cheese slices, or lactose-free cheese if dairy sensitive.

Sample mini-meals and snacks

- Smoothie: lactose-free milk, banana, peanut butter, whey isolate, and a drizzle of honey.

- Rice bowl: white rice with shredded chicken, olive oil, and a little broth to keep it moist.

- Oatmeal: make with milk, stir in protein powder, top with almond butter.

- Yogurt parfait: Greek yogurt with canned peaches and crushed low-fiber cereal.

- Avocado toast: sourdough, mashed avocado, soft-scrambled egg, olive oil.

Flare-friendly swaps

Make food easier to digest

During flares, textures matter. Go for soft, cooked, peeled, and de-seeded foods. Skins and roughage can be irritating when your colon is inflamed.

- Choose cooked carrots, zucchini, potatoes without skins, peeled apples or pears stewed until soft.

- Pick lean ground meats or slow-cooked meats instead of chewy cuts.

- Use smooth nut butters instead of whole nuts.

- Try white rice or pasta over brown grains until symptoms settle.

Fiber: not the enemy, just needs finesse

In remission, reintroduce gentle fibers graduallyoats, peeled fruits, well-cooked veggies. Fiber feeds gut bacteria and supports long-term health, but timing and texture are everything. During a flare, low-residue eating can reduce bathroom trips and abdominal pain; in calmer times, fiber slowly comes back like a guest you reintroduce to your home one room at a time.

Smart carbs

Energy your gut can use

Carbs are your easiest energy source during recovery. Focus on ones your gut likes:

- White rice, rice noodles, potatoes (no skins during flares), sourdough toast.

- Oatmeal or cream of rice.

- Ripe bananas and melons.

- Lactose-free or low-lactose dairy if tolerated.

Pair carbs with protein and fat to stabilize energy and support weight gain.

Fats that love you

Comforting, calorie-dense fats

Healthy fats are your quiet allies. Olive oil, avocado, and nut butters are often well tolerated. If high-fat meals trigger symptoms, split fat across meals and choose more monounsaturated fats (like olive oil and avocado) over heavy fried foods. A drizzle of oil here, a spoon of tahini therelittle rivers of calories flowing into your day.

Move gently

Light exercise for lean mass

Exercise doesn't have to mean burpees. In fact, please no burpees during a flare. Gentle movement can rebuild muscle and spark appetite:

- Two to three short resistance sessions per week: bodyweight squats to a chair, wall push-ups, light dumbbells, or resistance bands.

- Daily walks or relaxed cycling for circulation and mood.

- On tough days, five minutes counts. Consistency builds momentumand muscle.

Hydration help

Keep fluids simple

Diarrhea and frequent stools can dehydrate you fast. Sip regularly. If you're losing fluids, consider an oral rehydration solution or a DIY mix (water, a pinch of salt, a bit of sugar, plus a splash of juice). Cold or room-temp may be gentler than very hot drinks. Caffeine can stimulate the gut in some peoplenotice your pattern and adjust.

Supplements

When food isn't enough

Sometimes you need backup. Discuss with your clinician:

- Protein powder to meet daily protein targets.

- Omega-3s (fish oil) if you can't eat much fish.

- Vitamin D, B12, iron, or folate if labs show deficiencies (common in IBD).

- Lactase enzyme if lactose triggers symptoms.

- A low-lactose or elemental oral nutrition supplement for flares.

Always clear supplements with your GI team, especially during active inflammation or if you're on medications with interactions.

Your 10 tips

UC nutrition tips that work in real life

1) Add 250400 calories per day for two weeks, then reassess. If weight stabilizes, add another 100200.

2) Make protein non-negotiable: 2035 g at each of 35 eating moments daily.

3) Choose soft, high-calorie add-ins: olive oil, nut butters, avocado, lactose-free dairy.

4) Blend it: smoothies and creamy soups go down easy when appetite is low.

5) Cook your plants: peel, de-seed, and soften veggies and fruits during flares.

6) Eat every 34 hours: small, reliable intake beats big, daunting meals.

7) Keep a 714 day diary to learn your patterns and personalize your plan.

8) Move gently 35 days per week to direct calories toward lean mass.

9) Plan ahead: stock your kitchen with UC-friendly staples and snack packs.

10) Partner up: check in with your GI and a dietitian for lab monitoring and tailored advice.

Sample day

Flare-friendly menu idea

Morning: Creamy oatmeal cooked with lactose-free milk; stir in vanilla whey isolate and top with smooth almond butter and sliced ripe banana.

Snack: Greek yogurt (lactose-free) with canned peaches.

Lunch: White rice bowl with shredded chicken, olive oil drizzle, and soft carrots; a cup of bone broth on the side.

Snack: Smoothie with milk, peanut butter, banana, and a spoon of honey.

Dinner: Baked salmon or tofu, mashed potatoes (no skins), and well-cooked zucchini; side of sourdough with butter.

Evening: Cottage cheese or a lactose-free pudding if you want something sweet and soothing.

Mindset shifts

Eat with kindness

Food is not the enemyyou're rebuilding. Some days you'll hit your targets; other days, you'll just do your best. Both count. If appetite dips, set a timer and take three small bites every 15 minutes. Or sip on a smoothie over an hour. Progress, not perfection.

Personal story

A client I worked with felt defeated after losing weight during a stubborn flare. We started tiny: a spoon of peanut butter after breakfast, an extra drizzle of oil at lunch, a smoothie in the afternoon. She did five-minute resistance moves while coffee brewed. In four weeks, she gained three poundsher energy went up first, then her confidence. That spark was everything.

Team up

Work with your care team

Your doctor monitors inflammation and medications; a registered dietitian helps you turn that into meals you'll actually eat. Ask about labs for iron, B12, folate, vitamin D, and albumin. If you're losing weight fast, feeling faint, or struggling to keep foods down, get help sooner than later. Early adjustments can prevent hospital trips.

Common hurdles

What if nothing sounds good?

Try temperature and texture changes: cold smoothies, warm broths, or room-temp yogurt. Neutral flavors like vanilla, banana, or simple chicken and rice can be easier. Graze if full meals are daunting. A few high-calorie bites every hour add up.

What if dairy is tricky?

Lactose-free milk, yogurt, and cheese often work well. Or choose fortified soy milk for protein, or oat/almond milk with added protein powder. Hard cheeses typically have less lactose; test small amounts.

What about fiber supplements?

Some people tolerate partially hydrolyzed guar gum or psyllium in remission. During flares, fiber supplements may aggravate symptomstalk with your clinician before trying.

Track and tweak

Measure what matters

- Weight trend: weekly, not daily, to avoid noise.

- Energy, stool frequency, and urgency: these tell you if your plan is kind to your gut.

- Waist and hips or simple strength markers (e.g., more reps, longer walks): indicators that gain is leaning toward muscle.

Stay encouraged

You've got this

Gaining weight with ulcerative colitis isn't about forcing food; it's about rebuilding trust with your body. Small, steady steps compoundone more spoonful of nut butter, one more set of light squats, one more glass of milk. Over weeks, those add up to strength you can feel.

What do you think about starting with one change from this list today? Maybe it's a daily smoothie, maybe it's adding olive oil to dinner, or maybe it's a five-minute movement break. Share your experiences, your wins, and even the rough days. If you have questions, don't hesitate to askyour path is personal, but you don't have to walk it alone.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.