title: Asian consensus on the relationship between obesity and gastrointestinal and liver diseases.
abstract: The incidence of obesity is increasing in Asia, with implications on gastrointestinal (GI) and liver diseases. The Gut and Obesity in Asia Workgroup comprises regional experts with the aim of studying relationship between obesity and the GI and liver diseases in Asia. Through literature review and the modified Delphi process, consensus statements examining the impact of obesity on esophageal, gastric, pancreatic, colorectal, and liver diseases, exploring relationship between gut microbiome and obesity, and assessing obesity therapies have been produced by the Gut and Obesity in Asia Workgroup. Sixteen experts participated with 9/15 statements having strong consensus (>80% agreement). The prevalence of obesity in Asia is increasing (100% percentage agreement in brackets), and this increased prevalence of obesity will result in a greater burden of obesity-related GI and liver diseases (93.8%). There was consensus that obesity increases the risk of gastric cancer (75%) and colorectal neoplasia (87.5%). Obesity was also associated with Barrett's esophagus and esophageal adenocarcinoma (66.7%) and pancreatic cancer (66.7%) in Asia. The prevalence of non-alcoholic fatty liver disease (NAFLD) in Asia is on the rise (100%), and the risk of NAFLD in Asia (100%) is increased by obesity. Obesity is a risk factor for the development of hepatocellular carcinoma (93.8%). Regarding therapy, it was agreed that bariatric surgery was an effective treatment modality for obesity (93.8%) but there was less agreement on its benefit for NAFLD (62.5%). These experts' consensus on obesity and GI diseases in Asia forms the basis for further research, and its translation into addressing this emerging issue.
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Jianyi Calvin
authors.initials: JC
authors.lastname: Koh
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Wai Mun
authors.initials: WM
authors.lastname: Loo
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Khean Lee
authors.initials: KL
authors.lastname: Goh
authors.affiliation: Jichi Medical School, Tochigi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wah Kheong
authors.initials: WK
authors.lastname: Chan
authors.affiliation: Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Wai Yan Philip
authors.initials: WY
authors.lastname: Chiu
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Sutep
authors.initials: S
authors.lastname: Gonlachanvit
authors.affiliation: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
authors.forename: Wei-Jei
authors.identifier: http://orcid.org/0000-0002-6486-7717
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Wei Jie Jonathan
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia.
authors.forename: Yeong Yeh
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia.
authors.forename: Laurentius A
authors.initials: LA
authors.lastname: Lesmana
authors.affiliation: The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: You-Ming
authors.initials: YM
authors.lastname: Li
authors.affiliation: Department of Internal Medicine, Graduate Institute of Clinical Medicine, Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taiwan.
authors.forename: Chun Jen
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Department of Lifestyle-Related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.affiliation: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Enders Kwok Wai
authors.initials: EK
authors.lastname: Ng
authors.affiliation: Department of Medicine, University of Santo Tomas, Manila, Philippines.
authors.forename: Jose D
authors.initials: JD
authors.lastname: Sollano
authors.affiliation: Department of Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Simon Kin Hung
authors.initials: SK
authors.lastname: Wong
authors.affiliation: Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
authors.forename: Vincent W S
authors.initials: VW
authors.lastname: Wong
authors.affiliation: Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Khek Yu
authors.initials: KY
authors.lastname: Ho
authors.affiliation: Department of Medicine, National University of Singapore, Singapore.
authors.forename: Yock Young
authors.initials: YY
authors.lastname: Dan
mesh_terms: D001208:Asia / Q000453:epidemiology; D044466:Asian People; D032921:Consensus; D003697:Delphi Technique; D019317:Evidence-Based Medicine; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D000069196:Gastrointestinal Microbiome; D041981:Gastrointestinal Tract / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
keywords: Barrett's esophagus; NAFLD; carcinogenesis and metastasis; clinical; esophageal neoplasms; gastric cancer: epidemiology and surveillance; hepatocellular carcinoma; microbial pathogenesis; pancreatic cancer