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Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease12

Long, Millie D. MD, MPH1,2; Crandall, Wallace V. MD3; Leibowitz, Ian H. MD4; Duffy, Lynn MD4; del Rosario, Fernando MD5; Kim, Sandra C. MD2,6; Integlia, Mark J. MD7; Berman, James MD8; Grunow, John MD9; Colletti, Richard B. MD10; Schoen, Bess T. MD11; Patel, Ashish S. MD12; Baron, Howard MD13; Israel, Esther MD14; Russell, George MD14; Ali, Sabina MD15; Herfarth, Hans H. MD1,2; Martin, Christopher MSPH1,2; Kappelman, Michael D. MD, MPH2,6on behalf of the ImproveCareNow Collaborative for Pediatric IBD

doi: 10.1002/ibd.21585
Original Article

Background: Obesity is a significant public health threat to children in the United States. The aims were to: 1) Determine the prevalence of obesity in a multicenter cohort of children with inflammatory bowel disease (IBD); 2) Evaluate whether overweight and obese status is associated with patient demographics or disease characteristics.

Methods: We used data from the ImproveCareNow Collaborative for pediatric IBD, a multicenter registry of children with IBD, collected between April 2007 and December 2009. Children ages 2–18 years were classified into body mass index (BMI) percentiles. Bivariate analyses and multivariate logistic regression were used to compare demographic and disease characteristics by overweight (BMI >85%) and obese (BMI >95%) status.

Results: The population consisted of 1598 children with IBD. The prevalence of overweight/obese status in pediatric IBD is 23.6%, (20.0% for Crohn's disease [CD] and 30.1% for ulcerative colitis [UC] and indeterminate colitis [IC]). African American race (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.10–2.48) and Medicaid insurance (OR 1.67, 95% CI 1.19–2.34) were positively associated with overweight/obese status. Prior IBD-related surgery (OR 1.73, 95% CI 1.07–2.82) was also associated with overweight and obese status in children with CD. Other disease characteristics were not associated with overweight and obesity in children with IBD.

Conclusions: Approximately one in five children with CD and one in three with UC are overweight or obese. Rates of obesity in UC are comparable to the general population. Obese IBD patients may have a more severe disease course, as indicated by increased need for surgery. Sociodemographic risk factors for obesity in the IBD population are similar to those in the general population. (Inflamm Bowel Dis 2010;)

1University of North Carolina at Chapel Hill, Department of Medicine, Division of Gastroenterology and Hepatology, Chapel Hill, North Carolina, 2Center for Gastrointestinal Biology and Disease, Chapel Hill, North Carolina, 3Division of Gastroenterology, Nationwide Children's Hospital, Columbus, Ohio, 4Inova Pediatric Digestive Disease Center, Fairfax, Virginia, 5Nemours Children's Clinic, Florida and Delaware, 6University of North Carolina at Chapel Hill, Department of Pediatrics, Division of Gastroenterology and Hepatology, Chapel Hill, North Carolina, 7Barbara Bush Children's Hospital, Portland, Maine, 8Department of Pediatrics, Loyola University, Chicago, Illinois, 9Department of Pediatrics, University of Oklahoma, Oklahoma City, Oklahoma, 10Department of Pediatrics, University of Vermont, Burlington, Vermont, 11Department of Pediatrics, Emory University, Atlanta, Georgia, 12Division of Pediatric Gastroenterology, UT Southwestern Medical Center and Children's Medical Center, Dallas, Texas, 13Pediatric Gastroenterology & Nutrition Associates, Las Vegas, Nevada, 14Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts and 15Division of Gastroenterology, Children's Hospital and Research Center, Oakland, California

University of North Carolina at Chapel Hill, Division of Gastroenterology and Hepatology, CB #7080, Chapel Hill, NC 27599–7080


Received 6 October 2010; Accepted 24 October 2010

Published online 17 December 2010 in Wiley Online Library (

Supported, in part, by grants from the NIH (T32 DK007634, 5-KL2-RR025746–02, P30 DK034987), and a junior faculty career development award from the Crohn's and Colitis Foundation of America.

© Crohn's & Colitis Foundation of America, Inc.
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