Open AccessEuropean guideline on obesity care in patients with gastrointestinal and liver diseases – Joint European Society for Clinical Nutrition and Metabolism / United European Gastroenterology guideline
Author(s) -
Bischoff Stephan C.,
Barazzoni Rocco,
Busetto Luca,
CampmansKuijpers Marjo,
Cardinale Vincenzo,
Chermesh Irit,
Eshraghian Ahad,
Kani Haluk Tarik,
Khannoussi Wafaa,
Lacaze Laurence,
LéonSanz Miguel,
Mendive Juan M.,
Müller Michael W.,
Ockenga Johann,
Tacke Frank,
Thorell Anders,
Bender Darija,
Weimann Arved,
Cuerda Cristina
Publication year - 2022
Publication title -
united european gastroenterology journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1002/ueg2.12280
Subject(s) - medicine , guideline , liver disease , gerd , pancreatitis , obesity , disease , fatty liver , irritable bowel syndrome , metabolic syndrome , cirrhosis , gastroenterology , pathology , reflux
Background Patients with chronic gastrointestinal (GI) disease such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), celiac disease, gastroesophageal reflux disease (GERD), pancreatitis, and chronic liver disease (CLD) often suffer from obesity because of coincidence (IBD, IBS, celiac disease) or related pathophysiology (GERD, pancreatitis and CLD). It is unclear if such patients need a particular diagnostic and treatment that differs from the needs of lean GI patients. The present guideline addresses this question according to current knowledge and evidence. Objective The objective of the guideline is to give advice to all professionals working in the field of gastroenterology care including physicians, surgeons, dietitians and others how to handle patients with GI disease and obesity. Methods The present guideline was developed according to the standard operating procedure for European Society for Clinical Nutrition and Metabolism guidelines, following the Scottish Intercollegiate Guidelines Network grading system (A, B, 0, and good practice point [GPP]). The procedure included an online voting (Delphi) and a final consensus conference. Results In 100 recommendations (3x A, 33x B, 24x 0, 40x GPP, all with a consensus grade of 90% or more) care of GI patients with obesity – including sarcopenic obesity – is addressed in a multidisciplinary way. A particular emphasis is on CLD, especially fatty liver disease, since such diseases are closely related to obesity, whereas liver cirrhosis is rather associated with sarcopenic obesity. A special chapter is dedicated to obesity care in patients undergoing bariatric surgery. The guideline focuses on adults, not on children, for whom data are scarce. Whether some of the recommendations apply to children must be left to the judgment of the experienced pediatrician. Conclusion The present guideline offers for the first time evidence‐based advice how to care for patients with chronic GI diseases and concomitant obesity, an increasingly frequent constellation in clinical practice.