Recommendations on the management of severe obesity in patients with inflammatory bowel disease of the Spanish Group on Crohn’s Disease and Ulcerative Colitis (GETECCU), Spanish Society of Obesity (SEEDO), Spanish Association of Surgery (AEC) and Spanish Society of Digestive Endoscopy (SEED)

• Published in: Gastroenterología y Hepatología (English Edition) 2024-10, Vol.47 (8), p.906-923
• Main Authors: Domènech, Eugeni, Ciudin, Andreea, Balibrea, José María, Espinet-Coll, Eduard, Cañete, Fiorella, Flores, Lilliam, Ferrer-Márquez, Manuel, Turró, Román, Hernández-Camba, Alejandro, Zabana, Yamile, Gutiérrez, Ana, María Balibrea, José, Barreiro-de Acosta, Manuel, Butragueño, Javier, Ciudin Mihai, Andreea, Crujeiras, Ana B., del Pozo-García, Andrés J., Esteban López-Jamar, José Miguel, Dolores Frutos, M., Mañosa, Míriam, Rodríguez-Moranta, Francisco, Sabench, Fàtima
• Format: Article
• Language: English
• Subjects: Anti-obesity therapies; Bariatric surgery; Cirugía bariátrica; Colitis ulcerosa; Crohn’s disease; Enfermedad de Crohn; Enfermedad inflamatoria intestinal; Inflammatory bowel disease; Obesidad; Obesity; Tratamiento anti-obesidad; Ulcerative colitis
• ISSN: 2444-3824; 2444-3824
• DOI: 10.1016/j.gastre.2024.04.051

Obesity is a multifactorial, chronic, progressive and recurrent disease considered a public health issue worldwide and an important determinant of disability and death. In Spain, its current prevalence in the adult population is about 24% and an estimated prevalence in 2035 of 37%. Obesity increases the probability of several diseases linked to higher mortality such as diabetes, cardiovascular disease, hyperlipidemia, arterial hypertension, non-alcoholic fatty liver disease, several types of cancer, or obstructive sleep apnea. On the other hand, although the incidence of inflammatory bowel disease (IBD) is stabilizing in Western countries, its prevalence already exceeds 0.3%. Paralleling to general population, the current prevalence of obesity in adult patients with IBD is estimated at 15%–40%. Obesity in patients with IBD could entail, in addition to its already known impact on disability and mortality, a worse evolution of the IBD itself and a worse response to treatments. The aim of this document, performed in collaboration by four scientific societies involved in the clinical care of severe obesity and IBD, is to establish clear and concise recommendations on the therapeutic possibilities of severe or type III obesity in patients with IBD. The document establishes general recommendations on dietary, pharmacological, endoscopic, and surgical treatment of severe obesity in patients with IBD, as well as pre- and post-treatment evaluation. La obesidad es una enfermedad multifactorial, crónica, progresiva y recidivante considerada un problema de salud pública a nivel mundial y un importante determinante de discapacidad y muerte. En España su prevalencia actual en población adulta se sitúa en el 24% y se estima su incremento hasta el 37% en 2035. La obesidad aumenta la probabilidad de diversas enfermedades vinculadas a una mayor mortalidad como diabetes, enfermedades cardiovasculares, hiperlipidemia, hipertensión arterial, enfermedad del hígado graso no alcohólico, varios tipos de cáncer o apnea obstructiva del sueño. Por otra parte, aunque la incidencia de enfermedad inflamatoria intestinal (EII) se está estabilizando en los países occidentales, su prevalencia supera ya el 0,3%. Paralelamente a lo que ocurre en la población general, la prevalencia actual de obesidad en pacientes adultos con EII se estima en el 15%–40%. La obesidad en pacientes con EII podría comportar, además de su impacto sobre la discapacidad y mortalidad ya conocido, una peor evolución d