Rewind about 10 years, and you may remember the booming trend of people going on gluten-free diets. Sections of gluten-free products popped up in grocery stores, restaurant menus had an increase in options labeled “GF,” and more people adopted the gluten-free diet, which they viewed as healthier and helpful with weight loss.
But being gluten-free isn’t just a health trend. An estimated 3 million Americans have celiac disease, where eating gluten can cause damage to the small intestine, leading to gastrointestinal issues. May is Celiac Disease Awareness Month, so we talked to gastroenterologist and HMSA medical director Kristi Lopez, M.D., who shares what symptoms you should look for, ways to manage the condition, and how you can continue finding joy in food even with the diagnosis.
What is celiac disease?
Celiac disease is a chronic digestive condition where eating gluten (a protein found in wheat, barley, and rye) causes your immune system to attack the lining of your small intestine.
“This immune reaction leads to inflammation and damage of the villi, which are finger-like projections that absorb nutrients from the food you eat,” explains Dr. Lopez. “When those villi are damaged, your body can’t properly absorb essential nutrients like iron, calcium, and vitamin D.”
Some people may then experience symptoms like diarrhea, bloating, weight loss, anemia, fatigue, and thinning bones (osteoporosis). But with more than 200 symptoms associated with the disease, they can vary from person to person, which makes diagnosing celiac disease a challenge.
“If you’re experiencing ongoing digestive symptoms, low energy, unexplained weight loss, or low bone density, don’t ignore it,” says Dr. Lopez. “Ask your doctor if you should be tested for celiac disease. Diagnosis is simple and life-changing.”
A blood test can determine whether you have celiac disease, but a biopsy is the most accurate way to tell if you have the condition.
No cure, but don’t panic
Getting a diagnosis can be a relief, but it can also be stressful knowing that your lifestyle must change. There’s currently no medication or cure for celiac disease.
“The only proven treatment is a strict, lifelong gluten-free diet,” says Dr. Lopez. “Following it may seem like a big change, but it’s also your path to feeling better, preventing long-term complications, and living a healthy life.”
For many people, changing eating habits can be overwhelming. Dr. Lopez helps her patients by taking a step-by-step approach: teaching them how to read food labels, working with a nutritionist or dietician, and building meals around safe, naturally gluten-free foods. The goal is to help them understand what’s happening in their body, how food impacts their health, and why diet matters, which can empower them to feel confident managing it.
“We emphasize this isn’t about restriction – it’s about healing,” says Dr. Lopez. “Most patients start to feel better within weeks of removing gluten, and that’s a powerful motivation to stick with the gluten-free nutrition plan.”
New eating habits
While cutting out gluten can be a challenge, those with celiac disease can still love their food.
“Gluten-free doesn’t mean flavor-free,” says Dr. Lopez. “We encourage patients to explore new recipes, try naturally gluten-free cuisines, and take advantage of the many gluten-free alternatives available today – from pasta and bread to baked goods.”
Many naturally gluten-free foods are already part of Hawaii’s local cuisine, like fresh fish, vegetables, fruits, rice, and sweet potatoes. Restaurants and grocery stores have also come a long way in offering safe options for those with celiac disease.
“Finding joy in food is about shifting your mindset: focusing on what you can enjoy, discovering new flavors, and celebrating that your new way of eating is helping you feel better and live healthier,” says Dr. Lopez.
Strong support circle
Celiac disease can feel isolating for patients since they must constantly check food labels, ask about ingredients at restaurants, and avoid cross-contamination at home or in shared kitchens. But family and friends can help make someone with celiac feel supported.
“Emotional support is just as important as dietary support,” adds Dr. Lopez. “Just knowing someone is willing to take the time to understand and include them can make a big difference.”
She suggests:
- Learning what gluten is and where it hides (in sauces like shoyu, seasonings, or even kitchen tools).
- Providing safe gluten-free options at meals.
- Choosing restaurants with gluten-free menus.
- Avoiding making the person feel like a burden or “high maintenance.”
“If you’ve already been diagnosed, know this: you’re not alone,” says Dr. Lopez. “With good information, the right care, and strong support, you can feel well, live fully, and still enjoy food—gluten-free and worry-free.”
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