Research shows obesity is a major risk factor for heartburn, which happens when stomach acid leaks out of the stomach and into the esophagus.

You may not think that obesity and heartburn are linked, but clinical guidance and research show that you may face a higher chance of experiencing heartburn if you live with obesity.

This article describes the link between obesity and heartburn and how losing weight may help to alleviate this complication. You can also find a list of medications to discuss with a healthcare team to help with heartburn.

Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak into the esophagus, the tube that connects the mouth and stomach. Doctors may use the term “GERD” synonymously with acid indigestion or heartburn, but they’re separate health issues.

A 2021 review shows that GERD is linked with obesity and increases the risk of GERD due to the following:

  • Increased likelihood of hiatal hernia (HH): People with obesity are at increased risk of developing a hiatal hernia (HH). This is a condition in which the upper section of the stomach bulges through a weakness in the diaphragm, the large muscle that separates the abdomen and chest.
  • Increased intra-abdominal pressure (IAP): Carrying excess weight around the abdomen increases IAP. This increase in pressure is more likely to force stomach contents back up into the esophagus.
  • Increased secretion of GERD-causing chemicals: People with obesity have higher levels of visceral fat, which is fat that sits around the internal organs. Scientists have found that visceral fat secretes chemicals called “adipocytokines” and that some of these chemicals may be involved in GERD and cancers of the esophagus.

The American Gastroenterological Association explains that losing excess weight can decrease abdominal fat and, thereby, ease pressure on the stomach and lower esophageal sphincter. This eased pressure, in turn, may ease GERD symptoms.

Weight loss may also cause a reduction in visceral fat stores, which should lead to a reduction in adipocytokine secretion and a decreased risk of GERD and related diseases of the esophagus.

A 2016 study of 15,295 people with previously reported GERD symptoms investigated the effect of weight loss on those symptoms.

The researchers found that weight loss or reduced waist circumference was linked to an improvement in GERD symptoms, but only among people with general or abdominal obesity. The researchers concluded that weight loss or weight reduction would be an important treatment option for individuals with obesity.

You can also read here about more benefits of weight loss beyond helping with heartburn.

The Food and Drug Administration (FDA) lists the following over-the-counter (OTC) treatment options for heartburn:

  • Antacids: These medications neutralize the stomach acid that causes heartburn. Examples of antacids include:
    • Mylanta
    • Rolaids
    • Tums
  • Histamine-2 (H2) blockers: These medications reduce stomach acid production and secretion. They typically begin working within 1–3 hours. Examples include:
    • cimetidine (e.g., Tagamet HB)
    • famotidine (e.g., Pepcid Complete, and Pepcid AC)
    • nizatidine (e.g., Axid AR)
  • Proton pump inhibitors: These medications also reduce stomach acid production and secretion. They take longer to work than H2 blockers, typically around 1–4 days. Examples include:

If an OTC medication doesn’t resolve your heartburn, consider talking with a doctor. They may recommend stronger medications via a prescription.

Below are some answers to frequently asked questions about obesity and GERD.

How does obesity predispose you to GERD?

Obesity can cause various changes that predispose a person to GERD. These changes include increasing the risk of an HH, increasing IAP, and increasing visceral fat and the related release of GERD-causing hormones and other chemicals.

Can having overweight cause digestive difficulties?

Having overweight can cause a range of digestive difficulties besides heartburn.

According to a 2017 review of obesity-related digestive diseases, researchers have linked obesity to the following digestive issues such as GERD, Barrett’s esophagus, erosive esophagitis, gallstones, and pancreatitis. That research also linked obesity to certain gastrointestinal (GI) cancers.

What’s the difference between heartburn and heart attack if you have obesity?

The American Heart Association (AHA) notes that people commonly mistake heartburn for heart pain or “angina” because both conditions can cause chest pain that radiates to the neck, throat, or jaw.

If you’re confused about the cause of chest pain, it’s best to seek medical attention right away.

The AHA advises people to seek emergency medical treatment by calling 911 or local emergency services for chest pain or other heart-related symptoms, which could indicate a heart attack.

Are you more likely to have heartburn if you are overweight?

Research indicates that a person is more likely to experience heartburn if they have overweight, especially if they carry excess weight around their abdomen. This link exists because the excess weight increases pressure on the stomach, which increases the likelihood of stomach acid leaking into the esophagus.

Research suggests that obesity is a risk factor for heartburn and GERD. People with obesity also tend to have high levels of visceral fat, which secretes GERD-causing hormones and other chemicals.

Not only is obesity a risk factor for GERD, but it also increases the risk of other digestive issues, such as gallstones, pancreatitis, and certain GI cancers.

You may want to consult with a healthcare team about any concerns with your weight and the effect it may have on your health.