European guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline

Abstract

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Burden of obesity in gastrointestinal and liver diseases

“…ESPEN brought together numerous experts responsible for the evaluation of aspects related to the epidemiology and aetiology of overweight and obesity, as well as pathophysiology, clinical manifestations, diagnostic procedures with a special interest in nutritional interventions as well as all available therapeutic. 1 The guideline 'European Guideline on Obesity care in patients with gastrointestinal and liver diseases-joint ESPEN/UEG guideline', included in this issue of the UEG Journal, is the result of this enthusiastic collaboration. 1 It is well known that obesity is a complex multifactorial disease characterised by the excessive accumulation of adipose tissue and low-grade inflammation which presents a health risk leading and leads to the development of associated chronic diseases of the digestive system.…”

“…1 The guideline 'European Guideline on Obesity care in patients with gastrointestinal and liver diseases-joint ESPEN/UEG guideline', included in this issue of the UEG Journal, is the result of this enthusiastic collaboration. 1 It is well known that obesity is a complex multifactorial disease characterised by the excessive accumulation of adipose tissue and low-grade inflammation which presents a health risk leading and leads to the development of associated chronic diseases of the digestive system. For example, obesity related fatty liver disease causes progressive changes in the liver parenchyma and puts patients on a higher risk for hepatocellular cellular carcinoma, in addition to the risk for malignancies elsewhere in the digestive system.…”

“…These range from application of biomarkers to advanced ultrasound methods for assessing the degree of fatty infiltration of the liver, or more advanced stages like fibrosis 12 From a therapeutic perspective this guideline emphasises important role of all known therapeutic options from dietetic interventions and lifestyle changes with an accent on physical activity to the bariatric surgery, and recently, medical therapy (anti-obesity drugs) in the obese patients with NAFLD/MAFLD. 1,13,14 It has been shown that obesity curtailing interventions improve histologic features of NAFLD. 14 A recent prospective cohort study confirmed that morbid obesity is associated with mortality outside but also on the liver transplantation waiting lists.…”

“…ESPEN brought together numerous experts responsible for the evaluation of aspects related to the epidemiology and aetiology of overweight and obesity, as well as pathophysiology, clinical manifestations, diagnostic procedures with a special interest in nutritional interventions as well as all available therapeutic. 1 …”

“… 2 , 3 Crohn's disease, which was previously almost synonymous with malnutrition, is now characterised by overweight and obesity as well as sarcopenic obesity as a sign of malnutrition and loss of muscle mass. 1 , 4 Along with all of its well‐known consequences, obesity in IBD patients significantly compromises the application of most of new treatment modalities, such as biological therapy. 5 , 6 , 7 Obesity can also compromise the results of surgical treatment such as bariatric surgery in IBD.…”