How Weight Affects GERD
Being overweight can contribute to symptoms of
gastroesophageal reflux (GERD)
After a review of several
studies, investigators found that excess weight
nearly doubled the risk of GERD
symptoms such as
heartburn, acid regurgitation, chest pain, and
People who were obese, defined as a body mass
index (BMI) greater than 30, were nearly three
times more likely to develop esophageal cancer
than those with a healthy body weight.
BMI is a measure of a person's weight in relation
to his/her height.
occurs when the valve between the stomach and
the esophagus fails to close properly. As a
result, the contents in the stomach, including
stomach acid, can spill up into the esophagus,
leading to erosion of the esophagus and, in some
cases, esophageal cancer.
The results point to a way to prevent and treat
and its associated complications.
Additionally, an important next step will be to investigate
whether weight loss actually improves GERD
symptoms and complications.
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Obesity Associated with GERD
"There is credible evidence to incriminate obesity
in yet another set of diseases," he says.
"Although there is little information on whether
losing weight will reverse the risk of these
complications, it is very likely that staying [at
a] normal weight helps reduce the risk of GERD
Dr. David A. Johnson, professor of medicine and
chief of gastroenterology at Eastern Virginia
Medical School, agrees, noting that weight loss
has been shown to improve a number of other
"The causal relationship is there and it would be
suggestive that reduction in obesity and
overweight status would be helpful for lots of
reasons," Dr. Johnson notes.
The new study findings come in the context of a
steady rise in both obesity and the complications
in the US and Western Europe. Nearly
two-thirds of American adults are overweight,
according to the Centers for Disease Control and
At the same time, the rate of esophageal
adenocarcinoma has quadrupled in the past 20 years
with an estimated 20 percent of US adults
suffering from GERD, the study authors report.
Abdominal Obesity a Culprit
But exactly how excess body weight increases GERD
symptoms and complications remains unclear. One
possibility is that too much weight in the abdomen
compresses the stomach and raises the pressure
inside, leading to gastric reflux.
Alternately, abdominal obesity can contribute to
the release of inflammatory substances that may
raise the risk of GERD.
Thirdly, many persons who are obese eat excessive
amounts of fat, and fatty foods can increase the
risk of GERD, explains Dr. El-Serag, assistant
professor of medicine at Baylor College of
Medicine in Houston.
The study results are based on an analysis of nine
studies conducted over 18 years. People who were
overweight, defined by a body mass index of 25 to
30, were 1.4 times as likely to develop GERD
symptoms, while people who were obese were nearly
twice as likely to develop symptoms compared to
those with a healthy body weight.
The study "adds another reason for patients to
remain a healthy weight," Dr. El-Serag says. "This
can help them avoid GERD
with its associated
nuisance, treatment, and potential complications,
including cancer of the esophagus.