{
  "abstract": "Introduction Obesity and related cardiometabolic comorbidities, including hypertension, dyslipidaemia, diabetes, metabolic dysfunction-associated steatotic liver disease and atherosclerotic cardiovascular disease, are increasingly prevalent among individuals with inflammatory bowel disease (IBD). These conditions influence disease activity, therapeutic response, surgical outcomes and overall quality of life, yet evidence remains fragmented. The Modulate Obesity and relateD metabolic complIcations For Yielding improvements in IBD outcomes (MODIFY-IBD) initiative aims to synthesise evidence and generate consensus recommendations to guide practice and future research in this area. This study describes a protocol for a structured evidence synthesis and Research ANd Development/University of California, Los Angeles (RAND/UCLA) Appropriateness Method (RUAM) consensus process.Methods and analysis We will conduct three systematic reviews and a structured evidence synthesis organised into three domains: (1) the impact of obesity on IBD outcomes, (2) the burden of cardiometabolic complications in IBD and (3) the management of overweight, obesity and cardiometabolic comorbidities in IBD. A multidisciplinary international panel of gastroenterologists, surgeons, endocrinologists, hepatologists, cardiologists and dietitians will assess each statement using the RAND/UCLA appropriateness method. Panellists will rate the appropriateness of each statement (only those that fall within their area of expertise) on a 1–9 scale (1–3=inappropriate, 4–6=uncertain and 7–9=appropriate), with medians rounded up (eg, 6.5=appropriate). Agreement will be assessed using the RAND Disagreement Index (DI<1.0=agreement).Ethics and dissemination This study will not involve direct patient participation, as it is based on evidence synthesis and expert consensus; therefore, formal research ethics committee approval will not be required. Patient representatives will contribute to the consensus process to provide contextual perspectives but no identifiable data will be collected.Findings will be disseminated through publication in peer-reviewed journals, presentation at major gastroenterology and IBD conferences and communication with professional societies. A lay summary and patient-friendly infographic will also be developed to facilitate translation of recommendations into clinical practice.PROSPERO registration numbers CRD420251178843: a systematic review of the impact of obesity on inflammatory bowel disease outcomes.CRD420251178799: a systematic review of cardiometabolic complications in inflammatory bowel disease.CRD420251174653: management of overweight, obesity and cardiometabolic comorbidities in inflammatory bowel disease: a systematic review.",
  "authors": [
    {
      "affiliations": [
        "Division of Gastroenterology, University of Nebraska Medical Center, Omaha, Nebraska, USA"
      ],
      "name": "Jalpa Devi"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, WashU Medicine, St Louis, Missouri, USA"
      ],
      "name": "Sami Samaan"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Priya Sehgal"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Mouhand Mohamed"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, WashU Medicine, St Louis, Missouri, USA"
      ],
      "name": "Matthew Vincent"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, WashU Medicine, St Louis, Missouri, USA"
      ],
      "name": "Shannon Coombs"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, WashU Medicine, St Louis, Missouri, USA"
      ],
      "name": "Michelle Doering"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"
      ],
      "name": "Edward L Barnes"
    },
    {
      "affiliations": [
        "Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Amanda M Johnson"
    },
    {
      "affiliations": [
        "F Widjaja Inflammatory Bowel Disease Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA"
      ],
      "name": "Andres J Yarur"
    },
    {
      "affiliations": [
        "Division of Gastroenterology, WashU Medicine, St Louis, Missouri, USA"
      ],
      "name": "Parakkal Deepak"
    }
  ],
  "title": "Modulate Obesity and relateD metabolic complIcations For Yielding improvements in IBD outcomes (MODIFY-IBD): consensus on obesity and cardiometabolic comorbidities in inflammatory bowel disease using systematic reviews and the RAND/UCLA appropriateness method",
  "uid": "1fd36bad-5fca-5d14-9b63-f0b77ea69a91"
}