Interaction of obesity and inflammatory bowel disease

Table 1 Clinical impact of obesity on inflammatory bowel disease

Medical therapy	Surgical therapy	Natural history and disease complications
Decreased clinical response to azathioprine[77]	Earlier time to 1st surgery[15]	Conflicting data:
Lower 6-thioguanine levels on treatment with azathioprine[78]	Higher rate of perioperative complications[112,114,119-121]	Higher prevalence of perianal disease[22]
Decrease likelihood of response to adalimumab[83]	Increased need for conversion from laparoscopic to open surgery[113,118]	Lower prevalence of penetrating disease[24]
Shorter time to loss of response to infliximab[92]		Increased hospitalization[22]
		Decreased IBD-related quality of life[23]
		Decreased healthcare utilization[14]

IBD: Inflammatory bowel disease.