A 22-year-old emaciated male presented to the gastroenterology clinic of our department with complaints of diarrhea and weight loss since the last 3 months. His old record revealed him to be a diagnosed case of celiac disease, having been diagnosed 3 years prior to this admission, which was based upon his Tissue Transglutaminase serology (TTG serology) and duodenal biopsy report (Figure 1). He was later started on gluten free diet (GFD) and was initially compliant on it for a year. Later on, he became non-compliant and had been so ever since then. Currently his loose stools were watery in consistency, occurring 7-8 times per day. They were foul smelling, being difficult to flush, associated with tenesmus and with weight loss of around 5 kgs during this same time period. He did not complain of decrease in his appetite during this time nor had any history of fever, nausea, vomiting or of dysphagia. On examination, he appeared severely wasted with thin brittle hair along with dry skin and had prominent costal margins (Figure 2). His initial lab reports showed a low hemoglobin 10.2 g/dL along with a low platelet count 102,000 109fL. He was also found to have a severe electrolyte in-balance along with a low potassium (2.5 mEq/L), a low calcium (7.6 mg/dL), low albumin 1.8 g/dL, high phosphate 6.4 mg/dL and deranged LFTs with a TBR 0.48 U/L, ALP 303 U/L, SGPT 101 U/L, SGOT 65 U/L GGT 29 U/L. His iron profile, B12 and folate levels were sent along with lipid profile, which were all within normal limits. Ultrasound abdomen was later done and revealed diffuse fatty liver. His currently height was 132cm, while his weight was of 11.5kg along with a BMI 6.8 kg/m2. A nutritionist was immediately taken on board and he was started on blendized diet along with total parenteral nutrition and with replacement of his deranged electrolytes. His condition later improved within a week followed by weight gain of 3 kgs in one week. His oral intake gradually improved and his intravenous nutritional support was gradually tapered off. He regained 4 kg of weight and was later discussed and advised for regular follow-ups.