Exocrine pancreatic insufficiency (EPI) causes malnutrition and weight loss rather than weight gain. Medications may help someone with EPI reach a moderate weight.

EPI is a condition in which the small intestine cannot properly digest food due to problems with enzymes that the pancreas produces. This can lead to malnutrition and weight loss.

This article describes the association between EPI and weight.

A person walking past weight scales on a tiled floor. -1Share on Pinterest
Guillermo de la Torre/Stocksy

There is no evidence that EPI causes obesity. In fact, experts commonly associate EPI with malnutrition and weight loss.

The standard treatment for EPI is pancreatic enzyme replacement therapy (PERT), which involves taking an oral pancreatic enzyme medication.

Taking the medication with meals and snacks helps the small intestine digest food. As the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains, PERT can help someone gain sufficient nutrients from the foods they eat. This can help with weight gain.

According to a 2019 review, there are five PERT medications available in the United States. These are:

  • Creon
  • Zenpep
  • Pancreaze
  • Pertzye
  • Viokase

The review notes that doctors should monitor people taking PERT to ensure they are gaining sufficient weight.

While PERT can help increase weight in people with EPI, there is no evidence of an association between PERT and obesity.

One of the reasons doctors prescribe EPI medications is to assist with typical dietary fat intake and promote weight gain.

These medications provide the digestive enzymes that the small intestine needs to properly digest food and absorb nutrients.

The time it takes to gain weight after starting EPI treatment may depend partly on the cause of the EPI.

A 2021 review refers to an older clinical trial from 1998, in which 21 people with unresectable pancreatic cancer received either PERT or a placebo.

On average, those receiving PERT gained around 1.2% of their initial body weight, while those not receiving the treatment lost around 3.7% of their initial body weight.

It is unclear how long it took the individuals in the treatment group to start gaining weight. However, the final average weight increase for the treatment group occurred within an 8-week period.

A person needs to contact their doctor if they develop possible symptoms of EPI, such as:

A doctor will perform a physical examination to check for possible signs of EPI and may run diagnostic tests to confirm the diagnosis. Following a positive diagnosis, the doctor will likely offer PERT treatment to help promote weight gain.

Doctors may also recommend additional lifestyle changes to help maintain a moderate weight and ease EPI symptoms. These may include:

  • avoiding alcohol
  • quitting smoking, if applicable
  • making dietary changes, such as:
    • taking dietary supplements, including fat-soluble vitamins and minerals
    • eating small, frequent meals
    • following a specific meal plan from a registered dietitian

Can EPI make it hard to lose weight?

There is no evidence that having EPI can make it hard to lose weight. On the contrary, having EPI can cause malnutrition and weight loss.

Can pancreatic problems cause weight gain?

According to the NIDDK, overweight and obesity can cause a range of health issues, including inflammation of the pancreas, known as pancreatitis.

However, once a person develops pancreatic problems, they are likely to experience weight loss as opposed to weight gain.

The National Pancreas Foundation explains that this occurs because the pancreas no longer secretes enough pancreatic enzymes for digestion and proper nutrient absorption.

Can you have overweight with pancreatic insufficiency?

A person may have overweight with EPI if the EPI developed due to overweight or obesity.

However, a person who does not receive treatment for EPI will begin to lose weight due to nutrient absorption issues.

Will I gain weight on Creon?

Creon is a delayed-release pancreatic enzyme capsule that helps with food digestion in children and adults. It is a PERT medication that doctors may use to promote proper nutrition and increase weight gain in people with EPI.

Exocrine pancreatic insufficiency (EPI) can lead to malnutrition and weight loss.

The standard treatment for EPI is pancreatic enzyme replacement therapy (PERT). This approach involves taking pancreatic enzyme capsules during meals and snacks to help with digestion and nutrient absorption. These pills can help promote weight gain.

Anyone who experiences symptoms of EPI needs to contact a doctor for a diagnosis and appropriate treatment. Besides malnutrition and weight loss, untreated EPI can lead to other complications, such as problems with night vision, reduced bone mass, and osteoporosis.