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Personalized diet program improves GERD in patients with obesity
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Patients with obesity who underwent personalized, multidisciplinary health education and monitoring over a 6-month period saw improvement in their GERD symptoms, as well as their quality of life and weight, according to a study published in The American Journal of Gastroenterology’s “Putting Patients First” special issue.
Rena Yadlapati, MD, MSHS, of the division of gastroenterology and hepatology at the University of Colorado Anschutz Medical Campus, and colleagues designed a program specifically to treat patients with obesity and GERD, which they tested in a prospective mixed methods feasibility study.
“Weight loss is recognized as an effective treatment for [GERD],” Yadlapati told Healio Gastroenterology and Liver Disease. “However, there is a paucity of clinical programs that effectively promote weight management in reflux disease.”
Yadlapati said a multidisciplinary team developed The Reflux Improvement and Monitoring (TRIM) program, a 6-month plan that consisted of an initial consultation followed by 3 weekly sessions and then 5 monthly sessions. The initial consultation included a baseline weigh-in, standardized education, personalized goal-setting, weekly meal planning and instructions on how to use nutrition tracking tools. Educators reviewed these goals and reinforced lessons at the ensuing follow-up sessions, according to the study.
Patients with a GERD diagnosis and a BMI of 30 kg/m2 or greater were eligible for the study. Researchers invited each eligible patient to participate in TRIM and then separated the patients into two groups: those who agreed to participate (+TRIM, n = 52) and those who declined enrollment (–TRIM, n = 89).
Quantitative analysis consisting of pre- to post-intervention comparison within the +TRIM cohort showed the baseline mean GerdQ score (8.7±2.9) significantly decreased at 3 months (7.5±2.2, P < .01) and 6 months (7.4±1.9, P = .02). When compared with the –TRIM cohort, the decrease in percent excess body weight (%EBW) for patients in the +Trim cohort was significantly greater at 3 months (1.1 vs. 2 points; beta = 0.95, 95% CI 1.9 to 0.1), 6 months (1.0 vs. 3.3 points; beta = 2.4, 95% CI 3.5 to 1.2), and 12 months (0.1 vs. 3.7 points, beta = 3.8, 95% CI 6.5 to 1.2).
In an additional qualitative analysis, a patient focus group called TRIM a “beneficial combined approach to manage GERD and lose weight,” according to the study.
“Compared to eligible patients that did not enroll, patients that participated in TRIM had significantly greater weight loss. In addition, patients that participated in TRIM had significant symptom reduction,” Yadlapati said. “TRIM is a feasible clinical decision support tool that promotes patient-centered weight management for GERD and should be adopted across all centers.”
The “Putting Patients First” issue features studies built on patient-reported outcomes and showcases patients’ experiences with their disease, according to a press release. – by Alex Young
Disclosures: The authors reported no relevant financial disclosures.
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