GI-supervised weight loss program leads to weight loss in GERD, NAFLD
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SAN ANTONIO — A comprehensive gastroenterologist-supervised weight management program that includes nutrition education and behavioral support groups may lead to significant weight loss in patients with obesity with non-alcoholic fatty liver and GERD, according to findings presented at the American College of Gastroenterology Annual Meeting.
Naresh T. Gunaratnam, MD, and colleagues evaluated the outcomes of a weight loss program aimed at achieving a 10% total body weight loss at 3 months, which are known determinants of improved GERD and non-alcoholic fatty liver disease (NAFLD).
Gunaratnam, the research director at Huron Gastroenterology in Michigan, told Healio Gastroenterology and Liver Disease that while many doctors know how to treat the end results of obesity such as diabetes and hypertension, treating the cause is often overlooked.
“The problem is that we, in medicine, are not trained in medical school residencies and fellowships (in managing obesity) beyond telling people go home, exercise and eat right and we know that does not work,” he said. “I became frustrated by this because, in GI, we see the effects of obesity earlier than other specialties. The most prevalent liver disease is non-alcoholic fatty liver disease, which correlates to obesity and right now the soon-to-be leading cause of cirrhosis, liver cancer and liver transplant – and up to a third of the U.S. population may have it.”
The researchers examined patients with NAFLD and GERD who were seen at the clinic between May 2017 and January 2019 who were offered participation in a medically supervised weight loss program. The program consisted of a calorie-restricted meal replacement diet, a supervised medical fitness diet and weekly behavioral support groups.
Gunaratnam and colleagues wrote whole-food, plant-based or Mediterranean diets were slowly reintroduced to the patients.
The researchers wrote of the patients in the study (n = 97; mean age, 56 years; 94% white), 34% were diagnosed with NAFLD alone while 66% had diagnoses of both NAFLD and GERD.
At the 3-month mark, 63% of patients lost at least 10% of total body weight, Gunaratnam and colleagues wrote. Patients who attended 50% or more of the behavioral support group meetings had a greater mean percentage of total body weight loss compared with patients who attended no meetings (11.9% vs. 10%; P = .042).
The researchers wrote that studies are continuing to determine weight loss sustainability past 1 year.
“We’ve been able to change the paradigm a little bit and demonstrate to patients that GI practices can do obesity management effectively. So, I hope that more practices will start thinking about offering this service line,” he said. – by Earl Holland Jr.
References:
Hawa F, et al. Abstract P1676. Presented at American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.
Hawa F, et al. Clin Gastroenterol Hepatol. 2019;doi:10.106/j.cgh.2019.02.036.
Disclosures: Gunaratnam is the co-founder and chief medical officer for Lean Medial, LLC an endobariatrics company and consultant to Nestle Health Sciences. Please see the study for all other authors relevant financial disclosures.