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P372. Severe obesity in Crohn's disease patients: prevalence and disease associations

B. Ungar1, U. Kopylov2, D. Goitein3, A. Lahat2, E. Bardan2, B. Avidan2, A. Lang2, Y. Maor2, R. Eliakim2, S. Ben-Horin2, 1Sheba Medical Center, Internal Medicine D, Ramat Gan, Israel, 2Sheba Medical Center, Gastroenterology Institute, Ramat Gan, Israel, 3Sheba Medical Center, Surgery C, Ramat Gan, Israel

Background

Crohn's Disease (CD) is frequently associated with weight loss and malnutrition. However, as prevalence of obesity increases worldwide, it may become a clinical problem even in CD patients.

Methods

A retrospective analysis of a computerized CD patients' database was performed to identify severely obese patients (BMI > 35). The prevalence of severely obese patients was compared to data of the general population (Mabat national survey). These patients were then compared to randomly selected non-obese CD patients (BMI < 30) in a 1:3 ratio, respectively.

Results

Thirteen severely obese patients out of 560 CD patients were found (2.3%), significantly lower than the prevalence in the general population (5.6%, P < 0.001). When compared to 39 non-obese CD patients, colonic disease was significantly more prevalent in severely obese CD patients (OR 7.3, 95% CI 1.8–29, p = 0.004), while complicated CD was less common in those patients (OR 0.25, 95% CI 0.07–0.92, p = 0.04). After adjustment for age, gender and smoking status only colonic disease remained associated with severe obesity (OR 5.7, 95% CI 1.3–24.65, P = 0.02). Notably, four of the severely obese CD patients had undergone laparoscopic sleeve gastrectomy for treatment of morbid obesity with a favorable surgical outcome.

Conclusion

Severe obesity is infrequent yet possible in CD. CD in severely obese patients is more often colonic but otherwise indistinguishable from non-obese patients. Sleeve gastrectomy is a viable therapeutic option for morbidly obese CD patients.