Effects of obesity on the course of inflammatory bowel disease

Abstract

Obesity is increasingly common among patients with inflammatory bowel disease (IBD). The interplay between proinflammatory states of obesity and the course of IBD is yet to be elucidated. We conducted a retrospective study of 55 patients with IBD over the course of 5 years (2012 to 2017). We documented various clinical outcomes (mean number of clinic visits, hospitalizations/ flares, procedures, and escalations in therapy) based on three initial weight groups: normal weight, overweight, and obese. There was an increasing trend in all clinical outcomes with increasing weight and a statistically significant difference in mean clinic visits (P ¼ 0.048) and mean hospitalizations/flares (P ¼ 0.004) when comparing normal-weight to obese individuals. Our study suggests that obesity influences burden of disease and treatment in IBD. This should encourage clinicians to treat obesity in IBD patients as an active problem because it may help improve clinical outcomes.

Role of Obesity, Mesenteric Adipose Tissue, and Adipokines in Inflammatory Bowel Diseases

“…In a more recent, retrospective study of 209 adult patients with CD, Singla et al [49] observed that patients with a higher BMI were more likely to present with extraintestinal manifestations. Pavelock et al [50], in their retrospective observational study on IBD patients (63% CD and 37% UC), found that obesity negatively influences the clinical course of IBD and may increase the burden of disease and treatment. They critically evaluated an increasing trend in needed health care and escalations of various therapies against obesity.…”

“…A number of authors have pointed out that reliance on BMI as a sole marker of obesity seems to be the serious limitation of studies on relationship between IBD and obesity. They indicated a poor linear relationship between BMI and total body fat and also suggested that body fat distribution would be more clinically significant than overall obesity [43,50,56,57].…”

What Was First, Obesity or Inflammatory Bowel Disease? What Does the Gut Microbiota Have to Do with It?

“…Pavelock et al, indicate more frequent hospitalizations of obese patients with IBD compared to those with normal body weight. They also suggest that in individuals with a BMI above 30.0 kg/m 2 , we should consider weight reduction under the supervision of specialists [ 52 ]. Similar conclusions were drawn by Yerushalmy-Feler et al, who demonstrated that both low and high BMI upon diagnosis in children was associated with a worse course of illness [ 53 ].…”

Is Biologic Therapy in Inflammatory Bowel Disease Contributing to the Obesity Epidemic? Just Weight One Year

“…Obesity in patients with IBD is rising, with cross-sectional studies showing that between 15 and 40% of patients with IBD are obese, although the pathogenesis is not entirely understood [2][3][4]. Smoking cessation and the use of corticosteroids for flares can contribute to weight gain.…”

“…The authors recruited a large cohort of patients, adjusted for age, gender, disease type, C-reactive protein (CRP), smoking history, therapy, and disease activity score using a prospective and observational study design. The study looks at multiple classes of biologic agents, whereas previous data have concentrated more deeply on anti-TNF agents [2]. Nevertheless, weights were taken at different times of the day and can vary drastically throughout the day.…”