Belly fat hampers effectiveness of meds for Crohn’s, Colitis.

Belly fat hampers effectiveness of meds for Crohn's, Colitis.

Excess Belly Fat May Impact Effectiveness of Medications for Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease (IBD), which includes illnesses like Crohn’s disease and ulcerative colitis, may not be effectively treated by certain medications if patients have excess belly fat, according to new research. This finding highlights the importance of considering the impact of obesity and metabolic syndrome on the effectiveness of treatment for IBD.

Dr. Andres Yarur, a gastroenterologist at Cedars-Sinai in Los Angeles, explained, “Even though biologic medications have significantly improved outcomes for our patients with Crohn’s disease or ulcerative colitis, some people do not respond well to these therapies. In our study, we found that the patients with higher amounts of internal abdominal fat were less likely to improve and experience remission from their disease.”

Unlike other anti-inflammatory drugs, biologics work by blocking targets that cause inflammation in the body. The researchers discovered that patients with higher levels of visceral fat, which is fat found deep within the abdomen surrounding important organs, had lower levels of biologic medications in their blood after treatment. Additionally, they experienced lower rates of steroid-free remission and bowel healing.

“It seems the fat tissue on the inner side of the abdomen, in particular, impacts treatment, so we may need to use higher doses of the drugs to help these patients,” said Dr. Gil Melmed, director of Inflammatory Bowel Disease Clinical Research at Cedars-Sinai.

The study involved 141 IBD patients who were treated with one of three biologic medications: infliximab (Remicade), ustekinumab (Stelara), or vedolizumab (Entyvio). The researchers found that higher visceral adiposity, or belly fat, was associated with higher levels of pro-inflammatory cytokines, suggesting that fat tissue promotes inflammation and increases resistance to biologic drug therapy.

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However, it remains uncertain whether lowering visceral fat or administering higher doses of medication would improve drug effectiveness. Therefore, Dr. Yarur suggested that investigating the use of drugs with different mechanisms of action, especially other small molecules, could be a potential solution. This further research is important, as obesity and metabolic syndrome become more prevalent.

The research findings were published on July 25 in the journal Gastroenterology ¹. It is essential to consider these results and explore alternatives to biologic treatments for IBD as the prevalence of obesity and metabolic syndrome continues to rise.

SLIDESHOW

Inflammatory Bowel Disease (IBD) Causes, Symptoms, Treatment

For more information on inflammatory bowel disease, head to the U.S. Centers for Disease Control and Prevention.

Source: Cedars-Sinai, news release, July 25, 2023