Abstract：
Obesity is a multifactorial, chronic, progressive and recurrent disease considered a public health issue worldwide and an important determinant of disability and death. In Spain, its current prevalence in the adult population is about 24% and an estimated prevalence in 2035 of 37%. Obesity increases the probability of several diseases linked to higher mortality such as diabetes, cardiovascular disease, hyperlipidemia, arterial hypertension, non-alcoholic fatty liver disease, several types of cancer, or obstructive sleep apnea. On the other hand, although the incidence of inflammatory bowel disease (IBD) is stabilizing in Western countries, its prevalence already exceeds 0.3%. Paralleling to general population, the current prevalence of obesity in adult patients with IBD is estimated at 15-40%. Obesity in patients with IBD could entail, in addition to its already known impact on disability and mortality, a worse evolution of the IBD itself and a worse response to treatments. The aim of this document, performed in collaboration by four scientific societies involved in the clinical care of severe obesity and IBD, is to establish clear and concise recommendations on the therapeutic possibilities of severe or typeIII obesity in patients with IBD. The document establishes general recommendations on dietary, pharmacological, endoscopic, and surgical treatment of severe obesity in patients with IBD, as well as pre- and post-treatment evaluation.
摘要：
肥胖是一个多因素的，慢性，进行性和复发性疾病被认为是全球范围内的公共卫生问题，也是残疾和死亡的重要决定因素。在西班牙,其目前在成人中的患病率约为24%,2035年的患病率估计为37%.肥胖增加了一些疾病的概率与更高的死亡率，如糖尿病，心血管疾病,高脂血症,动脉高血压,非酒精性脂肪性肝病,几种类型的癌症，或者阻塞性睡眠呼吸暂停。另一方面,尽管炎症性肠病（IBD）的发病率在西方国家趋于稳定，其患病率已经超过0.3%。与普通人群平行，目前成人IBD患者中肥胖的患病率估计为15-40%.IBD患者的肥胖可能会导致，除了已知对残疾和死亡率的影响外，IBD本身的进化更差，对治疗的反应更差。本文件的目的，由四个参与严重肥胖和IBD临床护理的科学学会合作进行，目的是就IBD患者严重或III型肥胖的治疗可能性建立清晰简洁的建议。该文件确立了饮食方面的一般性建议，药理学,内窥镜,和严重肥胖的IBD患者的手术治疗，以及治疗前和治疗后的评估。
