Nearly 30% of Inflammatory Bowel Disease Patients Are Obese... More Than Double in 13 Years

Professor Hwang Sungwook's Team at Asan Medical Center Tracks Over 10,000 Domestic Patients
Obesity Rate in Male Patients Rises from 15.1% to 37.7%
"Personalized Treatment Strategies Needed Considering Patient Characteristics"

As the prevalence of obesity continues to rise due to the influence of Westernized dietary habits and lifestyles, it has been found that the obesity rate among domestic patients with inflammatory bowel disease is increasing more rapidly than that of the general population.

Seongwook Hwang (left) and Minkyu Kim, professors at the Inflammatory Bowel Disease Center, Asan Medical Center, Seoul. Photo by Asan Medical Center

On July 28, a research team led by Professors Hwang Sungwook and Kim Minkyu at the Inflammatory Bowel Disease Center of Asan Medical Center in Seoul analyzed the body mass index (BMI) of 11,216 domestic patients with inflammatory bowel disease. Their findings showed that the average obesity rate among these patients increased from 13.1% in 2008 to 29.8% in 2021, a 2.3-fold rise over 13 years. During the same period, the obesity rate among the general population increased from 30.7% to 37.1%, a rise of only 6.4 percentage points, indicating that the obesity rate among patients with inflammatory bowel disease is increasing at a much faster pace.

In particular, when analyzing the trends in BMI changes by gender, male patients showed an increase approximately four times higher than that of female patients. The obesity rate among female patients rose by 5.8 percentage points, from 9.2% in 2008 to 15.0% in 2021. In contrast, the obesity rate among male patients surged by 22.6 percentage points, from 15.1% to 37.7% during the same period.

Along with the increase in obesity rates, hematological indicators related to metabolic syndrome, such as blood glucose and cholesterol, also showed a continuous upward trend. Blood glucose levels tended to rise above the normal range (70-99 mg/dL), and total cholesterol levels steadily increased within the normal range. In patients with Crohn's disease, triglyceride levels rose from an appropriate level in 2008 to a borderline level of 150 mg/dL or higher in 2021.

Inflammatory bowel disease, which is characterized by chronic inflammation of the gastrointestinal tract, mainly includes Crohn's disease and ulcerative colitis. Because it cannot be completely cured, appropriate treatment methods tailored to each patient's characteristics and symptoms must be implemented, and lifelong treatment and management are required. However, most previous studies have focused on White populations, who traditionally have higher obesity rates, and there has been a lack of detailed analysis of the obese population among Asian patients with inflammatory bowel disease.

In particular, the research team explained that, considering the difference between the Western obesity standard (BMI ≥ 30 kg/m²) and the Asian standard (BMI ≥ 25 kg/m²), it is necessary to establish treatment criteria and evidence specifically for Asian populations.

Obesity and metabolic syndrome are known not only to cause various complications, including cardiovascular and cerebrovascular diseases, but also to worsen the prognosis of inflammatory bowel disease. Patients with inflammatory bowel disease require systematic management, but there are limitations such as dietary restrictions, a history of intestinal resection surgery, and medications that can affect weight and metabolism, making it difficult to apply standard obesity management methods.

This study is significant in that it is the first to demonstrate the increase in obesity prevalence among patients by analyzing the largest dataset of inflammatory bowel disease patients in Asia. The research findings were published in the latest issue of the Journal of Gastroenterology.

Professor Hwang Sungwook stated, "In a situation where there is a lack of clinical evidence regarding obesity among Asian patients with inflammatory bowel disease, we have obtained important research results that demonstrate the association between inflammatory bowel disease and obesity rates," and added, "Based on these findings, we will focus on developing treatment strategies that take into account individual patient characteristics and can help improve long-term prognosis."