A Brief Report of the Epidemiology of Obesity in the Inflammatory Bowel Disease Population of Tayside, Scotland

Abstract

Aim: Obesity in inflammatory bowel disease (IBD), particularly Crohn’s disease (CD), has previously been considered unusual (3%). CD patients who are obese tend to have increased perianal complications and a higher level of disease activity on an annual basis. Obesity in Scotland has been documented to have increased over the last decade, and over half all men and women in Scotland are now considered to be overweight. This study aims to assess obesity prevalence in the IBD community in Tayside, Scotland. Methods: All IBD patients (n = 1,269) were considered for inclusion. Inclusion criteria required a weight measurement taken from the preceding 12 months and a height measurement within the last decade. 489 patients were included in the analysis. Results: 18% of the Tayside IBD population were obese in comparison to approximately 23% of the Scottish population on a whole. A further 38% of patients were over-weight, the same percentage as the general population. In the overweight and obese ulcerative colitis patients there were higher levels of surgery, but the converse was true in the CD group, where the normal-weight group had the highest levels of surgery. There were significantly more obese men and women with CD than with ulcerative colitis (P = 0.05). Conclusion: Obesity prevalence has increased in IBD patients. This is significant because of the known increased levels of postoperative complications, perianal disease and requirement for more aggressive medical therapy. Research needs to be done to look at the effects of obesity on the co-morbid associations of other diseases with IBD, in particular colorectal cancer, and to ascertain whether or not screening frequency should be altered depending on BMI.

Body Composition in Patients With Crohn’s Disease and Ulcerative Colitis

“…A previous study (6) reported earlier rates of 3% of obesity in DC, 32.4% of this population showing a BMI ≥25 kg/m². Comparison of the data suggests a drastic change in BMI of patients from the studies, demonstrating an increase in the rate of obese patients, as it has been observed in the general population (35) .…”

“…It is believed that this is related to increased number of comorbidities, such as diabetes, hypertension, thromboembolic disease, infections, cancer (7) . It is also associated with increased risk of complications such as advanced age at diagnosis, greater number of relapses of the disease, perianal disease incidence, more frequent hospitalizations (6) and postoperative complications, including wound infection and dehiscence of surgical anastomoses (35) . CD patients classified as overweight or obese (BMI >25 kg/m²) required surgical procedure for the treatment of the disease in earlier stage (24 months), as a result of complications, when compared to patients with low weight (BMI <18.5 kg/m²) (252 months) (14) .…”

“…CD patients classified as overweight or obese (BMI >25 kg/m²) required surgical procedure for the treatment of the disease in earlier stage (24 months), as a result of complications, when compared to patients with low weight (BMI <18.5 kg/m²) (252 months) (14) . An observational study conducted in Scotland in 2009 found that 18% of study participants with IBD were considered obese (BMI >30 kg/m 2 ) and there was a significantly higher number of obese patients with CD than with UC (P=0.05) (35) . A previous study (6) reported earlier rates of 3% of obesity in DC, 32.4% of this population showing a BMI ≥25 kg/m².…”

The microbiota in inflammatory bowel disease

“…In the overweight/obese cohort of UC patients there were higher levels of surgery, but the converse was true for the CD cohort. In that study there were significantly more obese patients with CD than with UC [46]. There has been an increase in weight and disease activity in patients with CD enrolling in clinical trials in the last 20 years [48].…”

“…Data from a northern European population reported that the prevalence of obese and overweight patients in an IBD population was 18 and 38 %, respectively [46]. In the overweight/obese cohort of UC patients there were higher levels of surgery, but the converse was true for the CD cohort.…”