Obesity, Metabolic Comorbidity Rates Up in Patients With Inflammatory Bowel Disease

Despite an obesity diagnosis affecting as many as 1 in 3 adults with inflammatory bowel disease (IBD), just 3.6% of adults with IBD who were eligible for weight loss medication received a prescription for it in 2019, according to study findings published in Crohn’s & Colitis 360.

“With obesity being a harbinger for metabolic syndrome, the increase in obesity in IBD patients was accompanied by a concomitant increase in the diseases associated with obesity in the past decade,” wrote corresponding author Gregory S. Cooper, MD, of the division of gastroenterology and hepatology at Case Western Reserve University/University Hospitals Cleveland Medical Center in Ohio, and coauthors. “However, this alarming rise in obesity was accompanied by a disproportionately small increase in anti-obesity pharmacotherapy, similar to general population.”

Researchers performed a retrospective analysis of population-level data from 2010 to 2019 to analyze trends in obesity and anti-obesity pharmacotherapy among adults with IBD. The study included nearly 40 million people.

The prevalence of obesity in adults with IBD was 37.3%, according to the study. The obesity prevalence was 36.9% among those with Crohn’s disease and 38.5% among those with ulcerative colitis.

Trend analyses revealed increases in both obesity and metabolic comorbidities in patients with IBD between 2010 to 2019. Over the 10-year period, rates of obesity increased from 19.7% to 30.1%, type 2 diabetes increased from 8.3% to 12.5%, hypertension increased from 25.1% to 33.9%, hyperlipidemia increased from 22.1% to 32.2%, and sleep apnea increased from 4.1% to 10.8%. 

Nevertheless, just 2.8% of eligible patients were prescribed anti-obesity medication over the 10-year span, the study found. In 2010, the rate of eligible patients who received anti-obesity pharmacotherapy was 1.4%. The rate increased to 3.6% of eligible patients in 2019.

“Obesity is emerging as one of the biggest threats to health care costs and utilization,” researchers wrote. “This large population-level study shows that IBD is characterized by obesity and metabolic derangements at rates that have consistently increased in the last decade.”

Reference:
Elangovan A, Shah R, Ali SMJ, Katz J, Cooper GS. High burden of obesity and low rates of weight loss pharmacotherapy in inflammatory bowel disease: 10-year trend. Crohns Colitis 360. Published online March 8, 2023. doi:10.1093/crocol/otad007