Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 8, 2015; 7(28): 2819-2828
Published online Dec 8, 2015. doi: 10.4254/wjh.v7.i28.2819
Treating morbid obesity in cirrhosis: A quest of holy grail
Naveen Kumar, Narendra Singh Choudhary
Naveen Kumar, Narendra Singh Choudhary, Department of Transplant Hepatology, Medanta Liver Institute, Medanta the Medicity, Gurgaon 122001, Haryana, India
Author contributions: Kumar N and Choudhary NS both wrote the paper.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Narendra Singh Choudhary, Consultant, Department of Transplant Hepatology, Medanta Liver Institute, Medanta the Medicity, CH Bakhtawar Singh Road, Gurgaon 122001, Haryana, India. docnarendra@gmail.com
Telephone: +91-124-4141414 Fax: +91-124-4834111
Received: June 28, 2015
Peer-review started: July 5, 2015
First decision: July 28, 2015
Revised: October 13, 2015
Accepted: November 17, 2015
Article in press: November 25, 2015
Published online: December 8, 2015
Abstract

The problem of obesity is increasing worldwide in epidemic proportions; the situation is similarly becoming more common in patients with cirrhosis which negatively affect the prognosis of disease and also makes liver transplantation difficult especially in the living donor liver transplantation setting where low graft to recipient weight ratio negatively affects survival. Treatment of obesity is difficult in cirrhosis due to difficulty in implementation of lifestyle measures, limited data on safety of anti-obesity drugs and high risk of surgery. Currently approved anti-obesity drugs have limited data in patients with cirrhosis. Bariatric surgery remains an option in selected compensated cirrhotic patients. Endoscopic interventions for obesity are emerging and are quite promising in patients with cirrhosis as these are minimally invasive. In present review, we briefly discuss various modalities of weight reduction in obese patients and their applicability in patients with cirrhosis.

Keywords: Obesity, Intragastric balloon, Antiobesity drugs, Bariatric surgery, Cirrhosis

Core tip: The rising obesity problem is also associated with increased incidence of simultaneous obesity and cirrhosis. This is a particularly difficult subset of obese patients to treat as there is difficulty in implementation of lifestyle measures, limited data on safety of anti-obesity drugs and high risk of surgery. In present review, we briefly discuss various modalities of weight reduction in obese patients and their applicability in patients with cirrhosis.