Gastrointestinal Complications of Obesity

Camilleri, Michael; Malhi, Harmeet; Acosta, Andrés

doi:10.1053/j.gastro.2016.12.052

Cited by 195 publications

(176 citation statements)

References 167 publications

(173 reference statements)

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“…As obesity is the fastest growing disease worldwide [5,6], the evidences and mechanisms of obesity-induced gastrointestinal neoplasia have been suggested [7,8]. There were several meta-analyses for evaluating the association between body mass index (BMI, kg/m 2 ) as level of body weight and risk of gastric cancer [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies

Bae

2020

Cancer Res Treat

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Original ArticlePurpose A previous meta-analysis (MA) published in 2009 reported that excess body weight was associated with an increased risk of gastric cancer in non-Asians, but not in Asians. The aim was to conduct a meta-epidemiological MA (MEMA) to evaluate association between excess body weight and the risk of gastric cancer in Asian adults with using the proposed classification of weight by body mass index (BMI) in Asian adults. Materials and MethodsThe selection criteria were population-based prospective cohort studies that measured BMI of cohort participants and evaluated a risk of gastric cancer. Overweight group (OW) and obesity group (OB) were defined as 23.0-24.9 and ! 25.0, respectively. A group only showing results for BMI over 23.0 was defined as overweight and obesity group (OWB). Random effect model was applied if I 2 value was over 50%. ResultsAfter four new studies were added through citation discovery tools, seven cohort studies with 21 datasets were selected finally for MEMA. The I 2 value of OW, OB, and OWB were 76.1%, 83.5%, and 97.1%, respectively. Only OWB in men had a I 2 value below 50% (22.5%) and showed a statistical significance with inverse association (summary relative risk, 0.79; 95% confidence interval, 0.77 to 0.81). ConclusionThis MEMA supported the hypothesis that OW might be a protective factor in gastric cancer risk in Asian adults. It will be necessary to conduct additional cohort studies with lengthening follow-up periods and re-analyzing the effect of overweight and obesity classified by the Asian criteria.

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Section: Introductionmentioning

confidence: 99%

Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies

Bae

2020

Cancer Res Treat

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“…Obesity is considered a direct cause of NAFLD . Associated with both visceral adiposity and insulin resistance, NAFLD is the most common type of pediatric liver disease .…”

Section: Clinical Aspects: Comorbid Conditionsmentioning

confidence: 99%

“…33 Obesity is considered a direct cause of NAFLD. 34 Associated with both visceral adiposity and insulin resistance, NAFLD is the most common type of pediatric liver disease. 2 NAFLD is a spectrum of liver disease that necessitates attention to dosage adjustments as may be appropriate for certain hepatically cleared drugs.…”

Section: Clinical Aspects: Comorbid Conditionsmentioning

confidence: 99%

Pediatric Obesity: Influence on Drug Dosing and Therapeutics

Ameer

Weintraub

2018

The Journal of Clinical Pharma

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Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of U.S. children and adolescents. Severe obesity (≥120% of the 95th percentile of body mass index (BMI) for age, or a BMI ≥ 35 kg/m2) is the fastest‐growing subgroup and now approaches 6% of all U.S. youth. Health consequences (eg, type 2 diabetes, coronary heart disease) are related in a dose‐dependent manner to severity of obesity. Because therapeutic interventions are less effective in severe obesity, prevention is a high priority. Treatment plans involving combinations of behavioral therapy, nutrition, and exercise achieve limited success. Only one drug, orlistat, is U.S. Food and Drug Administration approved for long‐term obesity management in adolescents 12 years and older. As part of comprehensive medication management, clinicians should consider the propensity for a given drug to aggravate weight gain and to consider alternatives that minimize weight impact. Medication management must take into account developmental changes as well as the pathophysiology of obesity and comorbidities. Despite expanding insight into obesity pathophysiology, there are gaps in its translation to therapeutic application. The historical construct of obesity as simply a fat‐storage disorder is fundamentally inaccurate. The approach to adjusting doses based solely on body size and extrapolating from therapeutic knowledge of adult obesity may be based on assumptions that are not fully substantiated. Classes of drugs commonly prescribed for comorbidities associated with obesity should be prioritized for clinical research evaluations aimed at optimizing dosing regimens in pediatric obesity.

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“…However, it also increases the risk for various gastrointestinal and liver diseases. For example, obesity is a direct cause of non‐alcoholic fatty liver disease and increases risk for gastro‐esophageal reflux disease, Barrett's esophagus and gall stones . However, only a few studies have investigated the relationship between obesity and abnormal bowel habits.…”

Section: Introductionmentioning

confidence: 99%

Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross‐sectional analysis of the 2009‐2010 National Health and Nutrition Examination Survey

Ballou

Singh

Rangan

et al. 2019

Aliment Pharmacol Ther

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Summary Background Obesity is associated with increased risk for various gastrointestinal and liver diseases. However, the relationship between obesity and abnormal bowel habits is poorly understood. Aim To investigate the relationship between body mass index (BMI) and bowel habit, controlling for clinical, demographic and dietary factors, in a representative sample of the United States adult population Methods Data were extracted from the 2009‐2010 National Health and Nutrition Examination Survey. Survey responses were included in this study if respondents completed the bowel health questionnaire (BHQ), were ≥20 years of age, and did not report history of IBD, celiac disease or colon cancer. BMI was divided into the following categories: underweight, normal weight, overweight, obese and severely obese. Stepwise logistic regression provided risk ratios of constipation and diarrhoea controlling for confounding factors (dietary, life‐style, psychological and medical). Results A total of 5126 respondents completed the BHQ, had BMI data available, and met eligibility criteria. Of these, 70 (1.40%) were underweight, 1350 (26.34%) were normal weight, 1731 (33.77%) were overweight, 1097 (21.40%) were obese and 878 (17.13%) were severely obese. Up to 8.5% of obese and 11.5% of severely obese individuals had chronic diarrhoea, compared to 4.5% of normal weight individuals. Stepwise regression revealed that severe obesity was independently associated with increased risk of diarrhoea. Conclusion Obesity is positively associated with chronic diarrhoea in a nationally representative US adult population after adjusting for several known confounding factors.

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Gastrointestinal Complications of Obesity

Cited by 195 publications

References 167 publications

Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies

Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies

Pediatric Obesity: Influence on Drug Dosing and Therapeutics

Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross‐sectional analysis of the 2009‐2010 National Health and Nutrition Examination Survey

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