Obesity and Gastroesophageal Reflux Disease

Man with indigestion
Image Source/Getty Images

Gastroesophageal reflux disease (GERD) is also commonly referred to as “acid reflux.” It describes a chronic disease of the digestive system in which stomach acid or even stomach contents can flow backward, or reflux, into the esophagus (the “food pipe” that connects your throat to your stomach).  

The symptoms of GERD can be experienced as heartburn, regurgitation, nausea, burping or even coughing, especially upon lying down to sleep.

Sometimes symptoms of GERD can also include difficulty swallowing, sore throat or hoarseness.

Causes of GERD

There are numerous causes of GERD, but one of the most common causes is obesity. Other causes include smoking, hiatal hernia (when the stomach slips up or bulges up into the diaphragm), pregnancy, diabetes, delayed stomach emptying, congenital disorders, and connective tissue disorders such as scleroderma, among others.

The Link Between Obesity and GERD

Obesity has been found to be associated with three related esophageal disorders: GERD, Barrett’s esophagus and esophageal cancer. Researchers have also found that the risk and intensity of acid reflux rises with increasing body mass index (BMI).

While the incidence of GERD is more common in obese individuals, the exact mechanism by which obesity causes acid reflux is still uncertain, and remains an area of active research.

Losing Weight Can Help

One of the most effective lifestyle changes for the management of GERD is weight loss.

In one recent study, researchers discovered that a majority of people who were overweight or obese had complete resolution of their GERD symptoms when they followed a structured weight-loss program that included dietary and behavioral changes as well as physical activity. The more weight that was lost, the greater the improvement in GERD symptoms.

In another study, weight loss by calorie restriction and increased physical activity resulted in significant improvement in GERD symptoms.

Other studies that focused on patients with morbid obesity who underwent gastric bypass surgery found that GERD symptoms improved as a result of the significant weight loss caused by the gastric bypass surgery. Inflammation of the esophagus, known as esophagitis, was improved as well.

Thus, by all indications, losing weight can significantly improve symptoms of acid reflux, and may, in turn, reduce the long-term risk of other esophageal disorders, such as esophageal cancer, that have been tied to obesity.


Kushner N and Kushner R. Obesity & heartburn: what is the link? Accessed online at http://www.obesityaction.org/educational-resources/resource-articles-2/obesity-related-diseases/obesity-heartburn-what-is-the-link on April 16, 2015.

Akyuz F, Uyanikoglu A, Ermis F, Arici S, et al. Gastroesophageal reflux in asymptomatic obese subjects: An esophageal impedance-pH study. World J Gastroenterol 2015;21:3030-4.

Devendran N, Chauhan N, Armstrong D, Upton AR, Kamath MV. GERD and obesity: is the autonomic nervous system the missing link? Crit Rev Biomed Eng 2014;42:17-24.

Madalosso CA, Gurski RR, Callegari-Jacques SM, et al. The impact of gastric bypass on gastroesophageal reflux disease in morbidly obese patients. Ann Surg 2015 Jan 20. [Epub ahead of print]

Tai CM, Lee YC, Wu MS, et al. The effect of Roux-en-Y gastric bypass on gastroesophageal reflux disease in morbidly obese Chinese patients. Obes Surg 2009;19:565-70.

Continue Reading