Obesity and GERD: What’s the Connection?

In the last decade, the number of people who frequently experience acid reflux and GERD has almost doubled. The number on the scale has increased for most Americans as well. For the uninitiated, GERD is a chronic form of acid reflux, characterized by frequency of symptoms, typically occurring at least twice per week.

Left untreated, GERD can cause complications such as erosive esophagitis and sleep apnea, which can impact health and quality of life. Here, we’ll explore the connection between obesity and GERD, discuss ongoing research, and cover preventative and treatment options. Read on for a complete overview of obesity and GERD, or use the links below to skip to the section you’re most interested in.

• Does Obesity Cause GERD?
• Weight Gain and Other Risk Factors of GERD
• Can Losing Weight Help GERD?
• Weight loss tips
• Try Our Reflux Relief System

Does Obesity Cause GERD?

Several studies strongly suggest that obesity is a major risk factor for development of GERD, as well as related complications, including erosive esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma. But how and why are obesity and GERD connected?

There are several theories as to why obesity may contribute to GERD and other gastrointestinal issues:

1. Hiatal hernias: When the upper portion of your stomach bulges through the large muscle that separates your abdomen and chest, it's called a hiatal hernia. Hiatal hernias are extremely common in severely obese individuals, and in the study conducted by the Temple University School of Medicine, patients with a hiatial hernia were more likely to have esophagitis.
2. Abdominal pressure: Weight gain in the abdomen has also been cited as a cause of GERD and other gastrointestinal issues. As weight increases in the abdomen, excess pressure can inhibit the muscles in the lower esophageal sphincter (LES), which helps prevent the backflow of stomach acid into the esophagus.
3. Gastric volume:Temple University School of Medicine also suggests that obese individuals tend to have a higher volume of gastric contents, which may slow or alter how quickly the stomach is emptied. The theory suggests that the longer stomach acid remains in the body, the more opportunity for it to reflux, causing acid reflux, and if left untreated, GERD.

While there is still research being done on the link between having GERD and being overweight, it is clear that a connection exists. So just how serious is this problem? In the United States, where the obesity rate is the highest in the world, 19.8% of the population is affected by GERD.

When to see a doctor for GERD symptoms

If you have heartburn more than twice a week or if your symptoms continue after taking over-the-counter medicine, you should see a doctor. A doctor will perform tests to look for heartburn symptoms and probably diagnose you with more severe conditions, such as GERD. Other serious symptoms, like pain when swallowing, dizziness, shortness of breath, and blood in stool may necessitate a visit to your doctor.

Now that we’ve confirmed that obesity can cause GERD, let’s take a look at how weight gain and weight loss can impact your GERD symptoms.

Weight Gain and Other Risk Factors of GERD

While obesity and weight gain in general are considered major risk factors for developing GERD and associated gastrointestinal disorders, there are several other risks to consider. Let’s take a look.

According to the Mayo Clinic, the following are considered vulnerabilities for GERD and acid reflux symptoms:

• Hiatal hernias, a bulging of the top of the stomach up into the diaphragm
• Pregnancy
• Connective tissue disorders, such as scleroderma
• Delayed stomach emptying
• Smoking
• Eating large meals or eating late at night
• Consuming acid reflux triggers such as fatty or fried foods—learn about safer food alternatives in our blog about GERD diets.
• Drinking certain beverages, such as alcohol or coffee
• Taking certain medications, such as aspirin — read our post on pill induced esophagitis to learn how to take pills safely without triggering acid reflux.

This long list of risk factors can impact your likelihood of experiencing acid reflux symptoms, and if left untreated, may lead to GERD. Luckily, there are several ways you can prevent acid reflux and GERD:

1. Practice healthy eating
2. Maintain a healthy weight
3. Quit smoking
4. Avoid trigger foods
5. Use a pillow for heartburn relief at night—our Reflux Relief System is shaped to support the physician-recommended posture for sleeping with acid reflux, at an incline on your left side.

In addition to these preventative measures, there are also acid reflux medications and surgeries that can help treat your symptoms in the long-term.

Can Losing Weight Help GERD?

Yes, according to several studies, GERD may go away with weight loss or substantially reduce the severity and frequency of symptoms. According to Temple University’s publication, weight loss was shown to be an effective approach to GERD treatment in at least two instances:

• HUNT Research Centre, Norwegian University of Science and Technology study: Weight loss, in combination with a dose-dependent amount of antireflux medications decreased GERD symptoms and improved the effectiveness of overall treatment.
• Department of Gastroenterology, Veterans Affairs Medical Center study: The average weight loss was 13 kg, and the prevalence of GERD dropped from 37% to 15%, with 81% of participants reporting a decline in symptoms.

Weight loss tips

While there are several approaches to GERD and acid reflux management, weight loss can be among the most effective. Remember, weight loss is different for everyone and is best monitored with the help of your physician.

With that said, here are a few general weight loss guidelines to consider:

• If needed, seek guidance from a healthcare professional or nutritionist for an appropriate meal plan
• Avoid processed foods and fast food
• Limit the amount of sedentary time spent watching TV, working, etc.
• Get moving – walk to the park, go to the gym, and engage in fun, physical activities
• Get plenty of sleep

The benefits sustaining an optimal weight go far beyond the prevention of GERD. Those who are obese can suffer from high blood pressure, high cholesterol, diabetes and other problems – both physical and psychological.

As many individuals know, ongoing acid reflux is more than uncomfortable – it can cause painful symptoms, sleepless nights and lead to long-term health problems in adults and children. Given what we know about excess weight and GERD, we should all contribute to helping ourselves and younger generations steer clear of this and other obesity-related diseases.

Try Our Reflux Relief System

The Reflux Relief System from MedCline has been clinically proven to provide natural relief for patients suffering from GERD and acid reflux symptoms. Our three-part system is designed with the prescribed and validated posture for sleeping with acid reflux—on the left side and at an incline. With MedCline, you'll not only get a better night's sleep, as a result of reduced nighttime symptoms, but many of our patients experience long-term relief from reflux.

To learn more about how MedCline works, visit our FAQ page or speak with one of our Sleep Specialists for more information.

References:

1. Mendes, Elizabeth. “In U.S., Obesity Up in Nearly All Age Groups Since 2008”. GALLUP® Wellbeing. October 24, 2012.
2. Hoda M, J Kennard Fraley, Suhaib Abudayyeh, Kenneth W Fairly, Ussama S Javed, Heba Aboul-Fotouh, Nora Mattek, and Mark A Gilger. “Obesity and gastroesophageal reflux disease and gastroesophageal reflux symptoms in children”. Clinical and Experimental Gastroenterology. 2009; 2: 31–36.