TBA (22W148)

The need for specialist weight loss management, with consideration for pharmacological intervention, in treating obesity and Non-alcoholic fatty liver disease

Author(s)

Dr Thomas Sheehan, Dr William Shanhan, Prof Paud O'Regan, Dr Mary Jane Brassill

Department(s)/Institutions

Department of Gastroenterology/Endocrinology, Tipperary University Hospital

Introduction

There is a well established risk in developing non-alcoholic fatty liver disease (NAFLD) in obesity and Type 2 Diabetes Mellitus (T2DM). The first line management of NAFLD is weight loss through caloric restriction and lifestyle modifications. Patient may also benefit from pharmaceutical intervention.

Aims/Background

We assess the need for pharmacological intervention in NAFLD.

Method

100 T2DM patients had a BMI, Fib-4 score and transient elastography recorded for NAFLD screening. We then retrospectively analysed patients BMI over a 2 year period to assess significant weight loss with or without medications. In a small proportion of patients we managed to assess interval transient elastography.

Results

Non-biased screening of our diabetic population showed that 34-45% required a referral to gastroenterologist for suspected NAFLD, depending on screening method. When analysing weight loss, 49.1 % managed clinically significant weight loss with a medicinal adjunct vs 22% who without. Semaglutide was extremely effective, with 83% achieving reduction in BMI.

Conclusions

The incidence of obesity is rising in Ireland leading to more T2DM and NAFLD. Patients can struggle to achieve weight loss independently. These patients may benefit from counseliing, MDT and therapeutic aid.