Hépato-Gastro & Oncologie Digestive


IBD and obesity: the vicious cycle Volume 31, issue 1, January 2024


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1 CHU Nîmes, Carémeau, Service d’hépato-gastro-entérologie, Place du Professeur Debré, Nîmes, France
2 CHU Montpellier, Hôpital Saint-Éloi, Service d’hépato-gastro-entérologie A, Montpellier, France
3 Inserm UMRS 1256, Nutrition génétique et exposition aux risques environnementaux, Université de Lorraine, Nancy, France
4 CHRU Nancy, Département de gastroentérologie, Université de Lorraine, Nancy, France
5 Institut Hospitalo-Universitaire des maladies inflammatoires chroniques de l’intestin, IHU INFINY, Nancy, France
6 CHRU Nancy, Département de biochimie, biologie moléculaire, nutrition, Nancy, France
7 Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
* Correspondance : D. Arnone

The growing proportion of patients with IBD and obesity (15 to 40%) makes their management a critical therapeutic challenge. Obesity has a negative impact on the natural course of the disease, leads to an attenuated response to biotherapies and favors surgical complications. A nutritional assessment is therefore essential, and physicians should be aware of screening patients for malnutrition (even in the presence of obesity), sarcopenia and obesity-related complications. A multidisciplinary approach must be proposed to the patients: supervised changes in eating habits to avoid causing or worsen deficiencies, especially during inflammatory flare-ups, as well as practicing regular physical activity. Drug treatments for obesity, particularly GLP-1 analogs, can be proposed, although their impact on the evolution of inflammatory bowel disease has yet to be demonstrated. Bariatric surgery, when indicated, should be proposed to patients, as it has a demonstrated benefit on post-operative evolution in IBD.