Prevalence and impact of obesity in people with haemophilia

Review of literature and expert discussion around implementing weight management guidelines

S. Kahan, A. Cuker, R. F. Kushner, J. Maahs, Michael Recht, T. Wadden, T. Willis, S. Majumdar, D. Ungar, D. Cooper

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia-specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life. Data regarding bleeding tendency in PWH with coexisting obesity are largely inconclusive; however, some individuals may experience reduced joint bleeds following moderate weight loss. Additionally, conventional weight-based dosing of factor replacement therapy leads to increased treatment costs for PWH with obesity or overweight, suggesting pharmacoeconomic benefits of weight loss. Evidence-based recommendations for weight loss include behavioural strategies to reduce caloric intake and increase physical activity, pharmacotherapy and surgical therapy in appropriate patients. Unique considerations in PWH include bleed-related risks with physical activity; thus, healthcare professionals should advise patients on types and intensities of, and approaches to, physical activity, how to adjust treatment to accommodate exercise and how to manage potential activity-related bleeding. Increasing awareness of these issues may improve identification of PWH with coexisting obesity and referral to appropriate specialists, with potentially wide-ranging benefits in overall health and well-being.

Original languageEnglish (US)
JournalHaemophilia
DOIs
StateAccepted/In press - 2017

Fingerprint

Hemophilia A
Obesity
Guidelines
Weights and Measures
Exercise
Weight Loss
Quality of Life
Hemorrhage
Pharmaceutical Economics
Premature Mortality
Articular Range of Motion
Energy Intake
Health Care Costs
Lower Extremity
Therapeutics
Referral and Consultation
Joints
Delivery of Health Care
Drug Therapy
Health

Keywords

  • Comorbidities
  • Haemophilia
  • Health behaviour changer
  • Obesity
  • Overweight
  • Weight loss

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

Cite this

Prevalence and impact of obesity in people with haemophilia : Review of literature and expert discussion around implementing weight management guidelines. / Kahan, S.; Cuker, A.; Kushner, R. F.; Maahs, J.; Recht, Michael; Wadden, T.; Willis, T.; Majumdar, S.; Ungar, D.; Cooper, D.

In: Haemophilia, 2017.

Research output: Contribution to journalArticle

Kahan, S. ; Cuker, A. ; Kushner, R. F. ; Maahs, J. ; Recht, Michael ; Wadden, T. ; Willis, T. ; Majumdar, S. ; Ungar, D. ; Cooper, D. / Prevalence and impact of obesity in people with haemophilia : Review of literature and expert discussion around implementing weight management guidelines. In: Haemophilia. 2017.
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