Beyond Inflammation - A Multidisciplinary Approach to Managing Obesity and Cardiometabolic Risk in Inflammatory Bowel Disease

PURPOSE OF REVIEW: Adults with inflammatory bowel disease (IBD) demonstrate a high prevalence of obesity, metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic comorbidities. Cardiovascular disease (CVD) is a leading cause of mortality in IBD. This review examines cardiometabolic and obesity screening, and management within IBD models of care to optimise chronic disease management. RECENT FINDINGS: Obesity prevalence in IBD has increased to 40%. Chronic systemic inflammation driven by visceral adiposity, proinflammatory cytokine production, insulin resistance and vascular endothelial dysfunction represent a unifying mechanism linking IBD, MASLD and CVD. Proactive management of cardiometabolic risk is not prioritised within traditional IBD service models. Therapeutic approaches to manage obesity and lower CVD risk in this cohort with concurrent optimisation of IBD control include dietary and lifestyle intervention through to anti-obesity pharmacotherapy and bariatric procedures. Integrated multidisciplinary models of care that leverage existing infrastructure and shared-care partnerships with primary care, proactive risk identification and management strategies should be adopted within specialist IBD services. As obesity, MASLD and CVD emerge as major contributors of morbidity and mortality in IBD, failure to systematically address cardiometabolic risk represents a critical gap in contemporary IBD care. Embedding proactive screening and multidisciplinary management within existing IBD infrastructure offers immediate actionable opportunity to improve long-term outcomes beyond inflammatory control.