Recently, the United European Gastroenterology (UEG) released the "2022 UEG Opinion: Obesity and Digestive Health". Obesity is a major risk factor for chronic digestive diseases. The article mainly introduces the relationship between obesity and chronic digestive diseases and UEG's policy measures on obesity and digestive health.
01 Obesity and chronic digestive system diseases
Obesity AND CHRONIC DIGESTIVE DISEASES
Children's obesity
Children's obesity is an important risk factor for future digestive and metabolic diseases.
non-alcoholic fatty liver disease (non-alcoholic fatty liver disease, NAFLD) is the consequence of obesity in teenagers and has the risk of cirrhosis.
Obacteria and functional gastrointestinal disorders
4 out of every 10 adults suffer from one or more diseases of gut-brain interaction (DGBI) and obese people are more likely to develop symptoms of DGBI.
Obesity is strongly correlated with gastroesophageal reflux disease (GERD).
obesity and inflammatory bowel disease (inflammatory bowel disease, IBD)
20% of children and 40% of adults IBD patients are overweight or obese.
Western diet is believed to contribute to obesity and IBD.
obesity and/or visceral fat may increase the risk of surgical complications, hospitalization and postoperative recurrence in patients with IBD.
Obesity and liver disease
NAFLD is commonly found in obese or morbid obese people (the prevalence is 70%-95%).
NAFLD is the leading cause of liver-related death in Europe and is predicted to be the leading cause of end-stage liver disease unless urgent action is taken.
Obesity and digestive tract tumors
Obesity is a determined risk factor for various types of tumors, including pancreatic cancer , liver cancer and colorectal cancer.
In 2019, 4.6% of cancer deaths could be attributed to obesity.
02 Prevalence and treatment
PREVENT AND TREATMENT
The increase in overweight and obese people in Europe is worrying, and the COVID-19 pandemic has exacerbated this situation. There is an urgent need to develop prevention and treatment strategies at the individual and public health level.
Lifestyle related prevention
should promote people to choose a healthy lifestyle, such as following the Mediterranean diet and reducing alcohol consumption.
To solve the problem of excessive consumption of super-processed foods, which usually contain high calorie, high salt, high sugar and saturated fat.
should promote physical activity for the population to improve overall health and maintain a healthy weight.
Drug treatment
Although the prevalence of NAFLD in Europe is high, no effective drug treatment is currently approved for use.
Existing therapies focus mainly on NAFLD-related metabolic disorders.
Endoscopic and metabolic therapy
Obese patients who received intragastric balloon or endoscopic sleeve gastroplasty and lifestyle intervention lost more overall weight than those who received lifestyle intervention only.
The role of bariatric surgery
Sick obese patients should consider bariatric surgery.
bariatric surgery is associated with larger and faster weight loss compared to conventional treatments, and in most cases, long-term improvement in outcomes can be achieved. This has the potential to reduce all-cause mortality and the occurrence of obesity-related diseases. In addition, this can reduce the incidence of obesity-related cancers and cancer-related mortality.
In addition, bariatric surgery is accompanied by structured behavioral therapy, nutritional planning, and lifestyle changes to reduce calorie intake and increase exercise.
03 UEG's recommendations
According to the World Health Organization's guidelines, UEG recommends the following policy interventions:
effective prevention strategies for food, including food reformulation, mandatory positive nutrition labeling for packaging across the EU, food marketing restrictions (especially to protect children), taxation of unhealthy foods with high fat, high sugar and high salt, and increase the supply and affordability of healthy foods to affect consumer choices.
takes concerted action throughout the EU and member states to engage all relevant departments and create an environment for people and communities that are conducive to the restriction on the production and consumption of unhealthy foods.
Population prevention efforts must be targeted at all age groups, especially children, as early life interventions can have significant impacts.
carry out mass media publicity campaigns and educational programs in schools, focusing on improving overall health outcomes, not just weight loss, healthy school meals, and integrating food science into school curriculum.
Continuously adopt clinical practice guide for health care to provide effective, evidence-based obesity care and improve health care quality and patient outcomes.
R&D investment in innovative prevention and treatment plans.
References: Burra P, Arvanitakis M, Dias J A, et al. UEG position paper: Obesity and dietary health[J]. United European gastroenterology journal, 2022.
