Stephanie Gold, MD, is an instructor of medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist at the Mount Sinai Hospital.

Stephanie Gold, MD

Treating Obesity in IBD With GLP-1 Receptor Agonists

 is increasingly recognized as a modifiable risk factor in 

 (IBD), associated with poor medication response, higher surgical rates, and diminished quality of life. However, effective, IBD-specific weight management strategies have remained largely unstudied.

New prospective data from a dedicated IBD-metabolic clinic suggest that glucagon-like peptide-1 receptor agonists (GLP-1RAs), combined with structured lifestyle counseling, can deliver substantial weight loss and meaningful symptomatic benefit in this population, without compromising IBD disease control. The findings were presented by Stephanie Gold, MD, a gastroenterologist at the Icahn School of Medicine at Mount Sinai, at Digestive Disease Week (DDW) 2026 in Chicago, IL.

"Obesity really impacts IBD outcomes," Gold told 

. "Our patients who are overweight or have obesity respond poorly to medications, have increased surgical needs, and poor quality of life. It's super important that we're addressing it."

The analysis included 95 patients with IBD and overweight or obesity, defined as BMI ≥25 kg/m², seen during the first 12 months of a multidisciplinary IBD-Metabolic Clinic. All patients received structured lifestyle counseling, including a plating-method dietary strategy, daily walking, and twice-weekly resistance training.

Of the 95 patients, 50 (53%) additionally initiated a GLP-1RA based on standard eligibility criteria (BMI ≥27 kg/m² with comorbidity or BMI ≥30) and insurance or self-pay access. Weight, stool frequency and consistency, fatigue, and IBD-related complications were assessed at baseline and at 3, 6, 9, and 12 months. Of note, vibration-controlled transient elastography revealed hepatic steatosis in 72% of patients at baseline, underscoring the metabolic burden of this population.

Weight loss in the GLP-1RA group was notable and widened progressively over time. At 12 months, patients receiving GLP-1RA therapy achieved a median weight reduction of 20.9%, compared with a 3.0% gain in the lifestyle-only group (

<.01). Patients on GLP-1RAs were also significantly more likely to report improvements in stool frequency, stool consistency, and fatigue as early as 3 months. Rates of ER visits, hospitalizations, and changes in IBD therapy were similar between groups, with no severe adverse events recorded.

Gold highlighted constipation, a common GLP-1RA side effect in the general population, as an unexpected benefit in IBD patients with high baseline stool frequency.

"If they're having 4 or 5 loose stools per day, a little constipation is actually a nice benefit," she said.

Central to the program's success, Gold emphasized, is its multidisciplinary structure, bringing together a metabolic hepatologist, an IBD-trained dietitian, endobariatric and bariatric specialists, and endocrinology colleagues in a single clinical setting, reducing the delays and coordination challenges patients face when navigating multiple providers independently.

Looking ahead, Gold expressed hope that GLP-1RAs will become a routine part of IBD care, noting that gastroenterologists are often a patient's primary touchpoint with the healthcare system.

"We may be the only access point with the medical system for many of these patients," she said. "It's really important that we're identifying if they're overweight or obese and offering effective and safe strategies."

Editor's note: Gold reports no relevant disclosures.

Gold S, Tiao J, Collen A, et al. GLP-1RA Therapy Plus Lifestyle Counseling Significantly Improves Clinical and Patient-Reported Outcomes in Patients Living With IBD and Obesity. Presented at Digestive Disease Week (DDW) 2026; Chicago, IL; May 2–5, 2026.

Kaazan P, Seow W, Yong S, Heilbronn LK, Segal JP. The Impact of Obesity on Inflammatory Bowel Disease. Biomedicines. 2023;11(12):3256. Published 2023 Dec 8. doi:10.3390/biomedicines11123256

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Stephanie Gold, MD, explains prospective IBD-Metabolic Clinic data show GLP-1 RAs are safe and effective for weight management in IBD, with added benefits for bowel function and fatigue.

Adding GLP-1 RA Therapy to Lifestyle Counseling Drives Weight Loss, Improves Outcomes in IBD

New Research Supports GLP-1 RA Use in IBD for Weight Loss, Disease Control

 rates are rising across the US, with an estimated 1 in 5 adults in each state living with obesity. According to the US Centers for Disease Control and Prevention, the prevalence of obesity in US adults was 40.3% from 2021–2023.

 as a disease of malabsorption and underweight, patients with IBD are no exception to the obesity epidemic.

“In patients with IBD, [obesity] is not just associated with cardiometabolic disease, but also worsened IBD outcomes, increased disease flares, needs for surgery, and surgical complications, so it's incredibly important that we find a safe and effective treatment strategy,” Stephanie Gold, MD, an instructor of medicine at the Icahn School of Medicine at Mount Sinai and a gastroenterologist at the Mount Sinai Hospital, explained to 

While GLP-1 receptor agonists (GLP-1 RAs) have become an increasingly popular weight loss tool and may offer a potential solution to the rising rates of obesity, research on their use in IBD is limited.

Seeking to address this gap in research, Gold and Elizabeth Spencer, MD, MS, an assistant professor of pediatrics in the division of pediatric Gastroenterology at the Icahn School of Medicine at Mount Sinai and at the Mount Sinai Kravis Children’s Hospital, presented 4 abstracts on the use of GLP-1 RAs in patients with IBD at Digestive Disease Week (DDW) 2025, exploring recent prescribing trends, differences in patient demographics, as well as the safety and efficacy of this class of medications in this patient population.

Looking at GLP-1 RA prescription trends from 2020-2024 among patients with IBD at Mount Sinai, they found 6% of patients in the cohort were prescribed GLP-1 RAs—primarily for obesity—with semaglutide as the most common agent. Endocrinologists and primary care providers initiated most prescriptions, while GI specialists accounted for only a small fraction.

Importantly, Gold and Spencer’s research also demonstrated that GLP-1 RAs are safe in IBD populations, with minimal side effects and no evidence of worsening disease activity. They were also effective, with patients achieving average weight loss of 5%, 8%, and 10% at 3, 6, and 12 months, respectively, and rates of clinical remission in IBD improving over time.

“We have a medication that we know is effective and safe and may impact IBD outcomes,” Gold said. “For us, it was a win-win.”

“Most of the data so far on GLP-1s in IBD have come from big registry data where they don't have this kind of granularity on the clinical outcomes,” Spencer added. “They've talked about hospitalizations and surgeries, but they don't actually have the disease activity from the office visits, so this is something novel that we're able to present.”

Their research also confirmed the safety and efficacy of GLP-1 RAs in patients with perianal fistulizing Crohn’s disease, yielding “excellent” weight loss and a reduced need for surgical intervention relative to the year prior.

Phenotypically, Gold and Spencer found GLP-1 RA recipients were more likely to have less severe disease, colonic involvement, and later-onset Crohn’s, potentially reflecting physician hesitancy to use GLP-1 RAs in patients with more severe disease, though Spencer noted further research is needed.

Looking ahead, both experts emphasize the need for prospective studies to explore GLP-1 RA use beyond weight loss, including as adjunct therapy, in maintenance, and potentially for IBD prevention in high-risk populations. They also highlight interest in studying GLP-1 RAs in special IBD groups, such as patients with ileostomies or J-pouches, where slowed GI transit may offer added symptom relief.

Editors’ note: Gold and Spencer have not indicated any relevant disclosures.

US Centers for Disease Control and Prevention. New CDC Data Show Adult Obesity Prevalence Remains High. September 12, 2024. Accessed May 9, 2025. 

https://www.cdc.gov/media/releases/2024/p0912-adult-obesity.html

US Centers for Disease Control and Prevention. Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023. September 2024. Accessed May 9, 2025. 

https://www.cdc.gov/nchs/products/databriefs/db508.htm

Gold SL, Freid H, Shalom ES, et al. TRENDS IN GLUCAGON-LIKE PEPTIDE-1 AGONIST (GLP-1A) PRESCRIBING FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE. Abstract presented at Digestive Disease Week 2025 in San Diego, CA, from May 3 - May 6, 2025.

Gold SL, Freid H, Shalom ES, et al. GLUCAGON-LIKE PEPTIDE-1 AGONISTS IN INFLAMMATORY BOWEL DISEASE LEAD TO SIGNIFICANT WEIGHT LOSS AND IMPROVED CLINICAL REMISSION WITH MINIMAL SIDE EFFECTS. Abstract presented at Digestive Disease Week 2025 in San Diego, CA, from May 3 - May 6, 2025.

Bergenholtz S, Gold SL, Spencer EA, et al. GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST USE IN PATIENTS WITH PERIANAL FISTULIZING CROHN’S DISEASE IS WELL TOLERATED AND LEADS TO WEIGHT LOSS AND CLINICAL IMPROVEMENT IN FISTULA ACTIVITY. Abstract presented at Digestive Disease Week 2025 in San Diego, CA, from May 3 - May 6, 2025.

Spencer EA, Shalom ES, Freid H, et al. PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD) PRESCRIBED GLUCAGON-LIKE PEPTIDE-1 AGONISTS HAVE LESS SEVERE DISEASE AND REDUCED ADVANCED THERAPY UTILIZATION COMPARED TO THE GENERAL IBD POPULATION. Abstract presented at Digestive Disease Week 2025 in San Diego, CA, from May 3 - May 6, 2025.

A pair of experts discuss their research on trends in the use of GLP-1 RAs in patients with IBD as well as their safety and efficacy in this patient population.

Stephanie Gold, MD

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