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Office-Based Weight Loss Counseling Is Ineffective in Liver Transplant Recipients

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Abstract

Background

Weight gain after liver transplantation (LT) is a predictor of major morbidity and mortality post-LT; however, there are no data regarding weight loss following LT. The current study evaluates the effectiveness of standard lifestyle intervention in LT recipients.

Methods

All adult LT recipients with body mass index (BMI) ≥ 25 kg/m2 who followed up in post-LT clinic from January 2013 to January 2016 were given standard lifestyle advice based on societal recommendations which was reinforced at 24 weeks. Patients were followed for a total of 48 weeks to assess the impact of such advice on weight. Primary outcome was achieving weight loss ≥ 5% of the body weight after 48 weeks of follow-up.

Results

A total of 151 patients with 86 (56.0%) overweight and 65 (44.0%) obese patients were enrolled in the study. The mean BMI at baseline increased from 30.2 ± 3.7 to 30.9 ± 4.3 kg/m2 at 48-week follow-up (p = 0.001). Over the course of study, 58 (38.4%) patients lost any weight and weight loss greater than 5% and 10% occurred in only 18 (11.9%) and 8 (5.3%) of the entire cohort, respectively. Higher level of education was associated with increased likelihood of weight loss (OR 9.8, 95% CI 2.6, 36.9, p = 0.001), while nonalcoholic steatohepatitis as etiology of liver disease (HR 3.7, 95% CI 1.4, 9.7, p = 0.007) was associated with weight gain.

Conclusion

The practice of office-based lifestyle intervention is ineffective in achieving clinically significant weight loss in LT recipients, and additional strategies are required to mitigate post-LT weight gain.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

CVD:

Cardiovascular disease

HR:

Hazard ratio

HS:

High school

IQR:

Interquartile range

LT:

Liver transplantation

mTOR:

Mammalian target of rapamycin

NASH:

Nonalcoholic steatohepatitis

SPSS:

Statistical package for the social sciences

VCU:

Virginia Commonwealth University

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Funding

No funding/financial support was utilized for the research and manuscript.

Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University (VCU), MCV Box 980342, Richmond, VA, 23298-0342, USA

    Samarth S. Patel, Mohammad B. Siddiqui & Mohammad S. Siddiqui

  2. Department of Internal Medicine, VCU, Richmond, VA, USA

    Anchalia Chadrakumaran, Masoud Faridnia, Jose Hernandez Roman & Susan Wolver

  3. School of Medicine, VCU, Richmond, VA, USA

    Fei-Pi Lin, John Laurenzo & Joseph Clinton

  4. Division of Cardiology, Department of Internal Medicine, VCU Pauley Heart Center, VCU, Richmond, VA, USA

    Salvatore Carbone

  5. Department of Kinesiology and Health Sciences, VCU, Richmond, VA, USA

    Danielle Kirkman

  6. Division of Endocrinology Diabetes and Metabolism, Department of Internal Medicine, VCU, Richmond, VA, USA

    Francesco Celi

  7. Division of Transplant Surgery, Department of Surgery, VCU, Richmond, VA, USA

    Chandra Bhati

Authors
  1. Samarth S. Patel
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  14. Mohammad S. Siddiqui
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Contributions

Mohammad S. Siddiqui and Samarth Patel were involved in study concept and design; Fei-Pi Lin, John Laurenzo, and Joseph Clinton were involved in acquisition of data; Anchalia Chadrakumaran, Masoud Faridnia, and Jose Hernandez Roman analyzed the data; Samarth Patel and Mohammad B. Siddiqui drafted the manuscript; Salvatore Carbone, Danielle Kirkman, Susan Wolver, and Francesco Celi were involved in critical revision of the manuscript; Chandra Bhati and Mohammad S. Siddiqui supervised the study.

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Correspondence to Samarth S. Patel.

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Patel, S.S., Siddiqui, M.B., Chadrakumaran, A. et al. Office-Based Weight Loss Counseling Is Ineffective in Liver Transplant Recipients. Dig Dis Sci 65, 639–646 (2020). https://doi.org/10.1007/s10620-019-05800-6

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