Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study

Dorien Oomkens; Zlatan Mujagic; Annemarie de Vries; Andrea van der Meulen-de Jong; Tessa Straatmijer; Mark Löwenberg; Sander van der Marel; Rachel West; Alexander Bodelier; Fiona van Schaik; Marijn Visschedijk; Marjolijn Duijvestein; on Crohn Initiative on Crohn; Rinse Weersma; Janneke van der Woude; Michael van der Voorn; Philip Voorneveld; Pieter Stokkers; Nidhi Srivastava; Jael Smid; Maurice Russel; Tessa Römkens; Cyriel Ponsioen; Marieke Pierik; Bas Oldenburg; Liekele Oostenbrug; Loes Nissen; Peter Mensink; Wout Mares; Nofel Mahmmod; Jeroen Maljaars; Desiree Leemreis; Bindia Jharap; Dirk de Jong; Jeroen Jansen; Carmen Horjus; Marcel Groenen; Noortje Festen; Willemijn van Dop; Geert D’Haens; Gerard Dijkstra; Gerd Bouma; Nanne de Boer; Ad van Bodegraven

doi:10.1007/s10620-025-09052-5

Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study

Dorien Oomkens^*
, Zlatan Mujagic
, Annemarie de Vries
, Andrea van der Meulen-de Jong
, Tessa Straatmijer
, Mark Löwenberg
, Sander van der Marel
, Rachel West
, Alexander Bodelier
, Fiona van Schaik
, Marijn Visschedijk
, Marjolijn Duijvestein
, on Crohn Initiative on Crohn
, Rinse Weersma
, Janneke van der Woude
, Michael van der Voorn
, Philip Voorneveld
, Pieter Stokkers
, Nidhi Srivastava
, Jael Smid

Maurice Russel, Tessa Römkens, Cyriel Ponsioen, Marieke Pierik, Bas Oldenburg, Liekele Oostenbrug, Loes Nissen, Peter Mensink, Wout Mares, Nofel Mahmmod, Jeroen Maljaars, Desiree Leemreis, Bindia Jharap, Dirk de Jong, Jeroen Jansen, Carmen Horjus, Marcel Groenen, Noortje Festen, Willemijn van Dop, Geert D’Haens, Gerard Dijkstra, Gerd Bouma, Nanne de Boer, Ad van Bodegraven

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Purpose: To examine the impact of obesity on treatment outcomes in inflammatory bowel disease (IBD). Methods: Patients aged ≥ 16 years, with IBD, a documented baseline body mass index (BMI), and starting thiopurines and allopurinol, intravenous (iv) vedolizumab, subcutaneous (sc) vedolizumab, ustekinumab, ozanimod, filgotinib, or tofacitinib were selected from the Dutch Initiative on Crohn and Colitis (ICC) registry. Underweight patients (BMI < 18.5 mg/kg²) were excluded. The primary outcome was steroid-free clinical remission (i.e. Simple Clinical Colitis Activity Index (SCCAI) ≤ 2 for ulcerative colitis (UC) and IBD-unclassified (IBD-U), and Harvey Bradshaw Index (HBI) < 5 for Crohn’s disease (CD)) at week 24. Remission rates were compared between normal weight (BMI 18.5–25 kg/m²), and overweight (BMI 25–30 kg/m²), and obese (BMI ≥ 30 kg/m²) patients using binary logistic regression analyses. Multivariable regression analysis was used to correct for possible confounders. Results: Among 1066 patients with IBD, 619 had normal weight, 303 were overweight, and 144 were obese. At week 24, obese patients achieved steroid-free clinical remission less frequently (35.3%, OR = 0.578, 95% CI: 0.380–0.879, p = 0.010), supported by multivariable analysis (OR = 0.537, 95% CI: 0.346–0.832, p = 0.005). Conclusions: Obesity was associated with lower steroid-free clinical remission at week 24. Obese patients with IBD should be encouraged to lose weight not only to improve their overall health, but also to optimize their treatment outcomes.

Original language	English
Pages (from-to)	2786–2793
Number of pages	8
Journal	Digestive Diseases and Sciences
Volume	70
Issue number	8
Early online date	16 Apr 2025
DOIs	https://doi.org/10.1007/s10620-025-09052-5
Publication status	Published - 2025

Keywords

Biologics
Small molecules
Treatment response

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Oomkens, D., Mujagic, Z., de Vries, A., van der Meulen-de Jong, A., Straatmijer, T., Löwenberg, M., van der Marel, S., West, R., Bodelier, A., van Schaik, F., Visschedijk, M., Duijvestein, M., Initiative on Crohn, O. C., Weersma, R., van der Woude, J., van der Voorn, M., Voorneveld, P., Stokkers, P., Srivastava, N., ... van Bodegraven, A. (2025). Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study. Digestive Diseases and Sciences, 70(8), 2786–2793. https://doi.org/10.1007/s10620-025-09052-5

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title = "Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study",

abstract = "Purpose: To examine the impact of obesity on treatment outcomes in inflammatory bowel disease (IBD). Methods: Patients aged ≥ 16 years, with IBD, a documented baseline body mass index (BMI), and starting thiopurines and allopurinol, intravenous (iv) vedolizumab, subcutaneous (sc) vedolizumab, ustekinumab, ozanimod, filgotinib, or tofacitinib were selected from the Dutch Initiative on Crohn and Colitis (ICC) registry. Underweight patients (BMI < 18.5 mg/kg2) were excluded. The primary outcome was steroid-free clinical remission (i.e. Simple Clinical Colitis Activity Index (SCCAI) ≤ 2 for ulcerative colitis (UC) and IBD-unclassified (IBD-U), and Harvey Bradshaw Index (HBI) < 5 for Crohn{\textquoteright}s disease (CD)) at week 24. Remission rates were compared between normal weight (BMI 18.5–25 kg/m2), and overweight (BMI 25–30 kg/m2), and obese (BMI ≥ 30 kg/m2) patients using binary logistic regression analyses. Multivariable regression analysis was used to correct for possible confounders. Results: Among 1066 patients with IBD, 619 had normal weight, 303 were overweight, and 144 were obese. At week 24, obese patients achieved steroid-free clinical remission less frequently (35.3\%, OR = 0.578, 95\% CI: 0.380–0.879, p = 0.010), supported by multivariable analysis (OR = 0.537, 95\% CI: 0.346–0.832, p = 0.005). Conclusions: Obesity was associated with lower steroid-free clinical remission at week 24. Obese patients with IBD should be encouraged to lose weight not only to improve their overall health, but also to optimize their treatment outcomes.",

keywords = "Biologics, Small molecules, Treatment response",

author = "Dorien Oomkens and Zlatan Mujagic and \{de Vries\}, Annemarie and \{van der Meulen-de Jong\}, Andrea and Tessa Straatmijer and Mark L{\"o}wenberg and \{van der Marel\}, Sander and Rachel West and Alexander Bodelier and \{van Schaik\}, Fiona and Marijn Visschedijk and Marjolijn Duijvestein and \{Initiative on Crohn\}, \{on Crohn\} and Rinse Weersma and \{van der Woude\}, Janneke and \{van der Voorn\}, Michael and Philip Voorneveld and Pieter Stokkers and Nidhi Srivastava and Jael Smid and Maurice Russel and Tessa R{\"o}mkens and Cyriel Ponsioen and Marieke Pierik and Bas Oldenburg and Liekele Oostenbrug and Loes Nissen and Peter Mensink and Wout Mares and Nofel Mahmmod and Jeroen Maljaars and Desiree Leemreis and Bindia Jharap and \{de Jong\}, Dirk and Jeroen Jansen and Carmen Horjus and Marcel Groenen and Noortje Festen and \{van Dop\}, Willemijn and Geert D{\textquoteright}Haens and Gerard Dijkstra and Gerd Bouma and \{de Boer\}, Nanne and \{van Bodegraven\}, Ad",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2025.",

year = "2025",

doi = "10.1007/s10620-025-09052-5",

language = "English",

volume = "70",

pages = "2786–2793",

journal = "Digestive Diseases and Sciences",

issn = "0163-2116",

publisher = "Springer",

number = "8",

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Oomkens, D, Mujagic, Z, de Vries, A, van der Meulen-de Jong, A, Straatmijer, T, Löwenberg, M, van der Marel, S, West, R, Bodelier, A, van Schaik, F, Visschedijk, M, Duijvestein, M, Initiative on Crohn, OC, Weersma, R, van der Woude, J, van der Voorn, M, Voorneveld, P, Stokkers, P, Srivastava, N, Smid, J, Russel, M, Römkens, T, Ponsioen, C, Pierik, M, Oldenburg, B, Oostenbrug, L, Nissen, L, Mensink, P, Mares, W, Mahmmod, N, Maljaars, J, Leemreis, D, Jharap, B, de Jong, D, Jansen, J, Horjus, C, Groenen, M, Festen, N, van Dop, W, D’Haens, G, Dijkstra, G, Bouma, G, de Boer, N & van Bodegraven, A 2025, 'Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study', Digestive Diseases and Sciences, vol. 70, no. 8, pp. 2786–2793. https://doi.org/10.1007/s10620-025-09052-5

TY - JOUR

T1 - Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease

T2 - A Nationwide Dutch Registry Study

AU - Oomkens, Dorien

AU - Mujagic, Zlatan

AU - de Vries, Annemarie

AU - van der Meulen-de Jong, Andrea

AU - Straatmijer, Tessa

AU - Löwenberg, Mark

AU - van der Marel, Sander

AU - West, Rachel

AU - Bodelier, Alexander

AU - van Schaik, Fiona

AU - Visschedijk, Marijn

AU - Duijvestein, Marjolijn

AU - Initiative on Crohn, on Crohn

AU - Weersma, Rinse

AU - van der Woude, Janneke

AU - van der Voorn, Michael

AU - Voorneveld, Philip

AU - Stokkers, Pieter

AU - Srivastava, Nidhi

AU - Smid, Jael

AU - Russel, Maurice

AU - Römkens, Tessa

AU - Ponsioen, Cyriel

AU - Pierik, Marieke

AU - Oldenburg, Bas

AU - Oostenbrug, Liekele

AU - Nissen, Loes

AU - Mensink, Peter

AU - Mares, Wout

AU - Mahmmod, Nofel

AU - Maljaars, Jeroen

AU - Leemreis, Desiree

AU - Jharap, Bindia

AU - de Jong, Dirk

AU - Jansen, Jeroen

AU - Horjus, Carmen

AU - Groenen, Marcel

AU - Festen, Noortje

AU - van Dop, Willemijn

AU - D’Haens, Geert

AU - Dijkstra, Gerard

AU - Bouma, Gerd

AU - de Boer, Nanne

AU - van Bodegraven, Ad

PY - 2025

Y1 - 2025

N2 - Purpose: To examine the impact of obesity on treatment outcomes in inflammatory bowel disease (IBD). Methods: Patients aged ≥ 16 years, with IBD, a documented baseline body mass index (BMI), and starting thiopurines and allopurinol, intravenous (iv) vedolizumab, subcutaneous (sc) vedolizumab, ustekinumab, ozanimod, filgotinib, or tofacitinib were selected from the Dutch Initiative on Crohn and Colitis (ICC) registry. Underweight patients (BMI < 18.5 mg/kg2) were excluded. The primary outcome was steroid-free clinical remission (i.e. Simple Clinical Colitis Activity Index (SCCAI) ≤ 2 for ulcerative colitis (UC) and IBD-unclassified (IBD-U), and Harvey Bradshaw Index (HBI) < 5 for Crohn’s disease (CD)) at week 24. Remission rates were compared between normal weight (BMI 18.5–25 kg/m2), and overweight (BMI 25–30 kg/m2), and obese (BMI ≥ 30 kg/m2) patients using binary logistic regression analyses. Multivariable regression analysis was used to correct for possible confounders. Results: Among 1066 patients with IBD, 619 had normal weight, 303 were overweight, and 144 were obese. At week 24, obese patients achieved steroid-free clinical remission less frequently (35.3%, OR = 0.578, 95% CI: 0.380–0.879, p = 0.010), supported by multivariable analysis (OR = 0.537, 95% CI: 0.346–0.832, p = 0.005). Conclusions: Obesity was associated with lower steroid-free clinical remission at week 24. Obese patients with IBD should be encouraged to lose weight not only to improve their overall health, but also to optimize their treatment outcomes.

AB - Purpose: To examine the impact of obesity on treatment outcomes in inflammatory bowel disease (IBD). Methods: Patients aged ≥ 16 years, with IBD, a documented baseline body mass index (BMI), and starting thiopurines and allopurinol, intravenous (iv) vedolizumab, subcutaneous (sc) vedolizumab, ustekinumab, ozanimod, filgotinib, or tofacitinib were selected from the Dutch Initiative on Crohn and Colitis (ICC) registry. Underweight patients (BMI < 18.5 mg/kg2) were excluded. The primary outcome was steroid-free clinical remission (i.e. Simple Clinical Colitis Activity Index (SCCAI) ≤ 2 for ulcerative colitis (UC) and IBD-unclassified (IBD-U), and Harvey Bradshaw Index (HBI) < 5 for Crohn’s disease (CD)) at week 24. Remission rates were compared between normal weight (BMI 18.5–25 kg/m2), and overweight (BMI 25–30 kg/m2), and obese (BMI ≥ 30 kg/m2) patients using binary logistic regression analyses. Multivariable regression analysis was used to correct for possible confounders. Results: Among 1066 patients with IBD, 619 had normal weight, 303 were overweight, and 144 were obese. At week 24, obese patients achieved steroid-free clinical remission less frequently (35.3%, OR = 0.578, 95% CI: 0.380–0.879, p = 0.010), supported by multivariable analysis (OR = 0.537, 95% CI: 0.346–0.832, p = 0.005). Conclusions: Obesity was associated with lower steroid-free clinical remission at week 24. Obese patients with IBD should be encouraged to lose weight not only to improve their overall health, but also to optimize their treatment outcomes.

KW - Biologics

KW - Small molecules

KW - Treatment response

UR - https://www.scopus.com/pages/publications/105002718061

U2 - 10.1007/s10620-025-09052-5

DO - 10.1007/s10620-025-09052-5

M3 - Article

AN - SCOPUS:105002718061

SN - 0163-2116

VL - 70

SP - 2786

EP - 2793

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

IS - 8

ER -

Obesity Is Associated with Inferior Clinical Treatment Outcomes in Inflammatory Bowel Disease: A Nationwide Dutch Registry Study

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