Abstract Background Appetite disturbances are common in patients with inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, and can contribute to malnutrition, weight loss, fatigue, and reduced quality of life. Prospective data evaluating the impact of disease activity, treatment, and patient characteristics on appetite remain limited. This study aimed to assess appetite over one year in IBD patients, analyze the influence of treatment and disease activity, and evaluate associated patient-centered outcomes. Methods This prospective single-center study included 63 consecutive IBD patients between January and December 2024. Inclusion criteria were age 18 years, confirmed Crohn’s disease or ulcerative colitis, and stable follow-up in a tertiary IBD center. Patients with recent gastrointestinal surgery, severe comorbidities affecting appetite, or medications known to alter appetite were excluded. Appetite was assessed at baseline and every three months using a validated Visual Analog Scale (VAS) and the Council on Nutrition Appetite Questionnaire (CNAQ). Disease activity was measured using the Crohn’s Disease Activity Index (CDAI) and partial Mayo score. Treatments included biologics, immunomodulators, mesalamine, and corticosteroids. Patient-centered outcomes included quality of life (IBDQ, SF-36), fatigue (VAS), BMI, unintentional weight loss, and work productivity. Results Among the 63 patients, 35 (56%) had Crohn’s disease and 28 (44%) had ulcerative colitis; mean age was 41 years, 49% female. Appetite scores were significantly lower during active disease compared to remission (VAS 4.9 vs 7.2, CNAQ 25 vs 30, p 0.01). Patients on corticosteroids had slightly higher appetite scores than those on biologics or immunomodulators. Reduced appetite was associated with lower IBDQ scores (158 vs 186, p 0.01), lower SF-36 physical and mental scores, higher fatigue (VAS 6.8 vs 4.5, p 0.01), unintentional weight loss (5% over 3 months), and decreased work productivity. Female patients, younger adults, and those with elevated CRP were more likely to report poor appetite. Appetite inversely correlated with disease activity and inflammatory markers. Longitudinal analysis showed improvement during remission and decline during flares. Conclusion In conclusion, appetite in IBD patients is strongly influenced by disease activity, treatment, inflammation, and patient characteristics. Routine assessment, early nutritional intervention, dietary counseling, and integration of appetite and quality-of-life metrics are essential for patient-centered management and optimization of clinical outcomes. Conflict of interest: Aouroud, Meryem: No conflict of interest Aouroud, Hala: No conflict of interest Nacir, Oussama: No conflict of interest Lairani, Fatima Ezzahra: No conflict of interest Ait Errami, Adil: No conflict of interest Oubaha, Sofia: No conflict of interest Samlani, Zouhour: No conflict of interest Krati, Khadija: No conflict of interest
Aouroud et al. (Thu,) studied this question.