P0690 - Consequences of Obesity and IBD: Insights From a Large Outpatient Cohort

Surya Khadilkar, MD¹, Katie Hsia, MD², Jennifer Youn, MD², Tanya Zeina, MD², Puja Rai, MD³, Akash Rastogi, MD, MBA², Sureya Hussani, MS², Samara Spence, BA⁴, Pranay Adavelly, ², Jason Yanes, BS², Jacob Kotlier, ⁵, Sonia Friedman, MD⁵, Alexander N.. Levy, MD^6
1Tufts University Medical Center, Boston, MA; ²Tufts Medical Center, Boston, MA; ³Tufts Medical Center, Cambridge, MA; ⁴Tufts University School of Medicine, Cambridge, MA; ⁵Tufts University School of Medicine, Boston, MA; ⁶Yale Medical School, New Haven, CT

Introduction: Previous studies have shown that obesity in inflammatory bowel disease (IBD) is associated with an increased risk of morbidity. We aimed to examine the effect of obesity on disease presentation and complications.

Methods: We conducted a retrospective chart review of all IBD patients treated at our tertiary care center between 1996 and 2022. Data collected included demographics, clinical characteristics and current medications. We defined underweight as body mass index (BMI) < 18.5, normal weight as 18.5-24.9, overweight 25.0-29.9 and obese as >30. Pearson’s Chi Squared with alpha 0.05 and cross tabulation were calculated using Excel and Minitab software.

Results: Of 1493 patients, the average age was 45.6 years and 50.8% were female. There were 775 (52%) patients with Crohn’s disease (CD) and 691 (46.4%) with ulcerative colitis (UC). Mean disease duration was 15.1 years. In total, 314 (22.2%) of the patients were obese. There was no significant correlation between obesity and Montreal classification for CD or UC.

Extra-intestinal manifestations (EIMs) were found in 429 patients (28%) and were more common in obese than non-obese IBD patients (p =0.024). Arthritic manifestations (7.3%) were the most common but were not more prevalent in obese patients. In all, 278 (26.1%) patients had a history of IBD abdominal surgery and 114 (7.6%) had a history of perianal surgery. Obesity did not increase the risk of having had previous IBD abdominal surgery (p=0.64) or perianal surgery (p=0.88).

Regarding medical therapy, 605 patients (62%) (CD: 423; UC:182) were currently prescribed biologic medications. Obese patients with CD (p=0.069) or UC (p=0.11) were not significantly more likely to require biologic therapy.

Medications for hyperlipidemia, hypertension and diabetes were more common in obese patients. Medications prescribed more frequently included aspirin (p=0.008), statins (p=0.00), ACE/ARBs (p=0.002) and metformin (p=0.00) (see Table 1) Opioid prescriptions did not correlate with BMI type.

Discussion: Obese IBD patients were more likely to have EIMs compared to patients in other weight categories. Obese IBD patients used significantly more medications for diabetes, hypertension and hyperlipidemia and there was a trend towards increased biologic use. Obesity did not have an impact on disease phenotype or surgical history. Further research should examine the impact of weight loss on reducing IBD complications and polypharmacy.



Disclosures:


Surya Khadilkar, MD¹, Katie Hsia, MD², Jennifer Youn, MD², Tanya Zeina, MD², Puja Rai, MD³, Akash Rastogi, MD, MBA², Sureya Hussani, MS², Samara Spence, BA⁴, Pranay Adavelly, ², Jason Yanes, BS², Jacob Kotlier, ⁵, Sonia Friedman, MD⁵, Alexander N.. Levy, MD⁶. P0690 - Consequences of Obesity and IBD: Insights From a Large Outpatient Cohort, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.