Obesity related gastrointestinal disorders including Non-Alcoholic Fatty Liver Disease (NAFLD) and Gastroesophageal Reflux Disease (GERD) are more frequent and usually present earlier than diabetes mellitus type 2 and cardiovascular disorders. This provides an opportunity for the gastroenterologist to intervene early with an effective weight loss therapy. We evaluated the outcomes of a gastroenterologist supervised weight loss program aimed at achieving a 10% total body weight (TBW) loss at 3 months, a known correlation with NAFLD and GERD regression.
Patients with NAFLD and GERD seen at the clinic between May, 2017 to January, 2019 were offered participation in a medically supervised weight loss program comprised of a calorie restricted (800 Kcal/day) meal replacement diet, supervised medical fitness program, and weekly behavioral support groups for 3 months. This was followed by monthly follow up visits with slow reintroduction of whole food plant-based or Mediterranean diet. Two-sample t-Test assuming equal variances was used for statistical analysis.
One hundred and fifty-three patients presented for their baseline office visit, 56 patients dropped out within 12 weeks of enrollment, and 97 patients with NAFLD (64 patients had both NAFLD and GERD) continue to participate in the program to date. At baseline, the 97 participants (68 Females), had a mean age of 56 years, and a mean BMI of 38 kg/m2. Average percentage weight loss was (4.1% ± 3.5%), (10.5% ± 4.7%), and (13.3% ± 6.5%) at 1 month, 3 months, and 6 months follow up respectively. At 3 months, 63% of patients had lost at least 10% of TBW. Furthermore, patients who attended > 50% of the offered behavioral support groups lost 11.9% TBW at 3 months compared to 10.9% and 9.5% TBW loss for those who attended 10 - 50% and < 10% respectively. Attending > 50% of behavioral support groups was associated with a statistically significant higher TBW loss at 3 months when compared to no attendance (11.9% versus 10%, P-value = 0.042).
Over 60% of patients who completed a 3 month follow up in a multifaceted, community based, gastroenterologist supervised, weight loss program have achieved a clinically significant TBW loss of at least 10%. Our results also suggest that incorporating weekly behavioral support groups into the program might be a useful adjunct to achieving a clinically significant weight loss in this patient population. Studies are ongoing to determine the sustainability of this weight loss over 1 year.