How Changes in Body Weight Affect GERD

It’s common knowledge that certain foods can trigger symptoms of gastroesophageal reflux disorder (GERD) — a condition characterized by frequent episodes of acid reflux, also known as heartburn.

But scientists and doctors have shown in a number of different studies that excess body weight — even being just slightly overweight — can also trigger the onset of GERD and influence its severity.

Similarly, there’s evidence that losing excess body weight can improve or even resolve symptoms of GERD.

It’s unclear exactly why extra body weight has an effect on GERD, but one likely explanation is that the extra weight puts pressure on your abdomen. This increases the risk that your lower esophageal sphincter (LES) — the ring of muscle between your esophagus and stomach — will relax when it shouldn’t.

Some studies have also suggested that high-calorie, high-fat, or even high-carbohydrate foods can contribute to GERD, but other research has not found a definitive correlation, suggesting that triggers vary greatly by person. (1)

If you have GERD and you’re overweight or obese, it may be worthwhile to talk to your doctor about how losing weight could improve your symptoms.

Here are some key takeaways from studies showing that your body weight plays a role in GERD, and that losing weight can have a positive impact on the condition.

In one study, researchers sought to find out whether relatively small changes in body weight — even within the bounds of normal weight — can affect the severity of acid reflux and related symptoms in women. (2)

The study found a clear correlation between a woman’s body mass index (BMI) and the presence of GERD symptoms. The researchers found that women who were overweight — defined by a body mass index of 25 to 29.9 — were more than twice as likely to develop acid reflux as those of normal weight. (2)

Women who were obese — with a BMI greater than 30 — had nearly triple the risk of GERD symptoms, like heartburn, acid regurgitation, chest pain, and difficulty swallowing.

Perhaps most surprising, though, was that small differences in body weight in women of normal weight — with a BMI of 21 to 24.9 — also affected the likelihood of developing GERD.

Even in women who started out with a normal body weight, an increase in BMI of more than 3.5 was associated with nearly triple the risk of experiencing frequent GERD symptoms.

Overall, out of 10,545 women in the study, 22 percent reported having GERD symptoms at least once a week. Among those with symptoms, 55 percent experienced both heartburn and acid regurgitation.

The scientists in this study stressed that people with GERD whose body weight is ideal shouldn’t try to lose weight. But if you’ve gained weight and noticed an increase in your symptoms, you may be able to reverse this situation by losing the weight again.

There’s strong evidence that if you’re obese, participating in a structured weight loss program can help ease symptoms of GERD.

In one study, 332 obese adults took part in a program that included dietary changes, increased physical activity, and behavioral strategies. (3) After 6 months, 97 percent had lost weight, with an average loss of 13 kilograms (29 pounds).

Over the same period, the incidence of GERD in the group dropped from 37 percent to 15 percent, with 81 percent of participants seeing a drop in their GERD symptom scores. Greater weight loss was associated with a larger reduction in GERD symptoms, although women in the study saw significant improvements with only 5 to 10 percent of their body weight lost.

In another study, researchers tested out a weight loss program called The Reflux Improvement and Monitoring (TRIM) Program, which provided participants with “personalized, multidisciplinary” health education and monitoring for a period of six months. (4)

As a result, participants — a group of 52 people with obesity — experienced significantly greater weight loss 3, 6, and 12 months after starting the program as compared with a similar group that didn’t enroll in the program.

Among TRIM participants, scores indicating GERD symptom severity dropped significantly after three months, and stayed significantly down after six months. At the same time, scores indicating GERD-related quality of life also improved, but not to a statistically significant degree — meaning that this improvement could have been due to chance.

Nevertheless, this small study showed that a multidisciplinary weight loss program aimed at people with GERD could result in weight loss, improved symptoms, and overall satisfaction with the program.

There are a number of factors that may determine whether it’s a good idea for you to try to lose weight to help manage your GERD.

One is whether you’ve gained weight in the recent past, and whether your GERD symptoms got worse after this happened. (2)

Another is whether you’re experiencing other negative health effects from being overweight or obese — such as high blood pressure or impaired glucose tolerance — that make losing weight an urgent priority.

Always talk to your doctor before starting on any weight loss program to make sure that it’s safe, given your current state of health.

Losing weight isn’t easy. But if it’s right for you, it may turn out to do more for your GERD than you imagined was possible.

Additional reporting by Quinn Phillips.