Researchers at the Mayo Clinic found that even moderate weight gain can exacerbate GERD. The study strongly suggests that weight loss through eating fewer calories and increased physical activity may be an effective treatment method, especially for overweight and obese patients.
Researchers from the study evaluated nearly 200 patients who were at least 18 years old and clinically obese, but otherwise considered “healthy.” Researchers calculated the patients’ body mass index (BMI) and data on the frequency and severity of their GERD-related symptoms.
Researchers measured participants’ BMI after restricting patient’s calories at six months, 12 months, and 18 months. They discovered that GERD symptoms, like acid reflux and heartburn, decreased significantly at each interval and improved throughout the entire 18-month study.
Other studies have been similarly convincing. The Center for GERD Care at the Texas GERD Institute (TGI) reviewed several studies and confirmed that excess weight nearly doubles the risk of GERD symptoms such as acid reflux, heartburn, chest pain, and difficulty swallowing.
Research published in The New England Journal of Medicine found that decreasing BMI by more than 3.5 points in normal-weight women (equal to losing approximately 10 to 15 pounds) decreased the occurrence of GERD symptoms by about 40 percent. A weight gain of 10 to 15 pounds was associated with an increased risk of frequent heartburn, acid reflux, and other GERD-related problems.
Why Does Losing Weight Help?
Johns Hopkins Medicine points out that because obesity and GERD are being diagnosed more frequently in the United States, a link between the conditions appears likely. Extra abdominal fat may increase pressure on your stomach, which can cause the lower esophageal sphincter to relax. When this happens, stomach contents can flow back up into your esophagus, leading to acid reflux and other GERD symptoms. You can prevent this cycle from occurring by losing weight.
TGI similarly reports that abdominal obesity may be at least partly to blame. Too much weight in the abdomen compresses the stomach and causes the pressure inside to rise. Abdominal obesity can also contribute to the release of inflammatory substances that can increase the risk of GERD.
Managing Weight Loss with GERD
The American Academy of Allergy, Asthma, & Immunology (AAAA) cites losing weight as an important lifestyle change to help manage GERD. In fact, in an interview in the journal Gastroenterology and Hepatology, Laura B. Gerson, MD, MSc,
recommends weight loss as first-line GERD treatment to most patients.
“If patients are able to lose weight, this lifestyle modification is very effective and can reduce or eliminate the need for medical therapy,” Gerson says. However, she acknowledges that effective and sustainable weight loss can be difficult for many patients.
The McKinley Health Center (MHC) at the University of Illinois and AAAA recommend the following dietary modifications as part of an appropriate diet for GERD patients.
These recommendations may help to lessen the likelihood of reflux and irritation of sensitive or inflamed esophageal tissue in addition to promoting weight loss:
- Decrease total calories: reducing your total fat and caloric intake will help promote weight loss.
- Eat less fat: high-fat meals (including fried foods) can decrease pressure on the lower esophageal sphincter and delay stomach emptying, increasing your risk of reflux.
- Avoid large meals: overeating can increase the chance that you’ll experience stomach pressure and reflux.
- Avoid heavy evening meals: eating a heavy meal at night has been associated with increased chance for weight gain. This is partly because you’re more unlikely to burn off excess calories from a meal eaten within a few hours of bedtime.
While these suggestions may help reduce reflux and other GERD symptoms, it’s important to remember that treatment of this condition often requires a multi-faceted approach that combines dietary and lifestyle modifications and possible drug therapy. Your healthcare provider can help you develop the right program to manage your discomfort and decrease your symptoms.