Pediatric Inflammatory Bowel Disease in the Setting of Obesity: A Paradigm Shift?

The percentage of IBD patients who are obese at diagnosis is steadily increasing. Malnutrition in IBD is associated with increased morbidity and therefore prompt nutritional management is essential to improve outcomes. Obesity, a form of malnutrition and an inflammatory state in itself, may affect diagnosis, treatment and prognosis. We present two obese pediatric IBD patients to demonstrate how obesity may negatively impact diagnosis and clinical course. In one case, the presence of obesity, despite significant weight loss, led to delayed diagnosis. In the other, obesity may have complicated the patient’s overall clinical course. Nutritional assessment based on BMI alone may be challenging and inaccurate in overweight or obese patients.