Practical guideline on obesity care in patients with gastrointestinal and liver diseases – Joint ESPEN/UEG guideline

• DOI: 10.1016/j.clnu.2023.03.021
• Publication Date: 2023-04-10T15:10:02Z
• Authors: Stephan C. Bischoff; Johann Ockenga; Ahad Eshraghian; Rocco Barazzoni; Luca Busetto; Marjo Campmans-Ku...; Vincenzo Cardinale; Irit Chermesh; Haluk Tarik Kani; Wafaa Khannoussi; Laurence Lacaze; Miguel Léon-Sanz; Juan M. Mendive; Michael W. Müller; Frank Tacke; Anders Thorell; Darija Vranesic B...; Arved Weimann; Cristina Cuerda
• Keywords: Internal Diseases; Sarcopenia; Tarımsal Bilimler; Yoğun Bakım Tıbbı; Beslenme ve Diyetetik; Yoğun Bakım; Sağlık Bilimleri; Critical Care and Intensive Care Medicine; Gastroesophageal reflux disease; İç Hastalıkları; Clinical Medicine (MED); Inflammatory bowel disease; Irritable Bowel Syndrome; Ziraat; Tarım Bilimleri; Klinik Tıp (MED); Tarım ve Çevre Bilimleri (AGE); Child; 2. Zero hunger; Nutrition and Dietetics; Sarcopenic obesity; Klinik Tıp; Agricultural Sciences; Liver Diseases; Agriculture; 3. Good health; Tıp; Gastroesophageal reflux disease; Inflammatory bowel disease; Irritable bowel syndrome, celiac disease; Obesity; Pancreatitis; Sarcopenic obesity; YOĞUN BAKIM; AGRICULTURAL SCIENCES; Gastroesophageal Reflux; Medicine; Adult; NUTRITION & DIETETICS; BESLENME VE DİYETETİK; Health Sciences; Humans; Beslenme ve Dietetik; Obesity; Irritable bowel syndrome, celiac disease; Internal Medicine Sciences; Pancreatiti; Intensive Care; Dahili Tıp Bilimleri; Agriculture & Environment Sciences (AGE); CLINICAL MEDICINE; Inflammatory Bowel Diseases; Irritable bowel syndrome; Celiac Disease; Pancreatitis; CRITICAL CARE MEDICINE; celiac disease

Patients with chronic gastrointestinal 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 gastrointestinal patients. The present guideline addresses this question according to current knowledge and evidence.The present practical guideline is intended for clinicians and practitioners in general medicine, gastroenterology, surgery and other obesity management, including dietitians and focuses on obesity care in patients with chronic gastrointestinal diseases.The present practical guideline is the shortened version of a previously published scientific guideline developed according to the standard operating procedure for ESPEN guidelines. The content has been re-structured and transformed into flow-charts that allow a quick navigation through the text.In 100 recommendations (3× A, 33× B, 24 × 0, 40× GPP, all with a consensus grade of 90% or more) care of gastrointestinal patients with obesity - including sarcopenic obesity - is addressed in a multidisciplinary way. A particular emphasis is on CLD, especially metabolic associated 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.The present practical guideline offers in a condensed way evidence-based advice how to care for patients with chronic gastrointestinal diseases and concomitant obesity, an increasingly frequent constellation in clinical practice.