Gastroesophageal reflux disease (GERD) and obesity are two of the most common health concerns today, and they are closely linked. As rates of obesity and abdominal weight gain rise, so does the prevalence of GERD. Understanding the connection between weight and reflux symptoms is a key step toward long-term relief and better health.
Obesity and Central Adiposity: Key Contributors to GERD
Carrying excess weight (especially around the abdomen) can put significant pressure on the stomach and digestive system. This abdominal fat, known as central adiposity, increases intra-abdominal pressure, which can cause stomach contents to push upward into the esophagus, resulting in acid reflux.
Obesity also raises the risk of developing a hiatal hernia, which further contributes to GERD by allowing part of the stomach to move into the chest area.
Mechanisms Linking Obesity to GERD
Obesity impacts the body in multiple ways that can trigger or worsen GERD. Increased abdominal pressure can weaken the lower esophageal sphincter (LES), the muscle that helps keep acid in the stomach where it belongs.
In addition, obesity-related inflammation and hormonal shifts can affect how the stomach empties and how much acid is produced, making reflux more frequent and more severe.
The High Correlation: What Research Says
Research consistently shows that GERD is more common in individuals with a higher Body Mass Index (BMI). Studies have found that the severity of GERD symptoms tends to increase with weight. However, the encouraging news is that even small amounts of weight loss can lead to noticeable improvements.
Reducing weight can ease pressure on the digestive system, improve LES function, and significantly decrease reflux symptoms.
“Patients often have more than one reason for their GERD symptoms,” says Dr. Jennifer Phan, a board-certified gastroenterologist serving as the Medical Director for the Hoag Irvine Advanced Endoscopy Center, Director of Bariatric Endoscopy and Program Director of the Advanced Endoscopy Fellowship.
“In patients with underlying obesity, it is important that we help address all the potential causes, including the discussion of weight management in order to ensure longterm success.”
Obesity Management to Decrease GERD Symptoms
Start with lifestyle changes. Small, sustainable steps can make a big impact:
- Eat balanced, portion-controlled meals
- Limit trigger foods like caffeine, spicy dishes, and acidic drinks
- Stay physically active with regular movement
- Avoid eating late at night
Consider medical treatment. Many people benefit from medications such as Antacids, H2 blockers, and Proton pump inhibitors (PPIs) for GERD.
Anti-obesity medications such as GLP1s or bariatric endoscopy can also be considered. Bariatric endoscopy is a non-surgical, minimally invasive approach to weight loss that uses a flexible tube with a camera (an endoscope) inserted through the mouth to access the stomach. It’s designed for individuals who may not qualify for—or prefer to avoid—traditional bariatric surgery.
Common bariatric endoscopic procedures include:
- Endoscopic sleeve gastroplasty (ESG): Stitches are placed inside the stomach to reduce its size and capacity, helping patients feel full sooner and eat less.
- Intragastric balloon placement: A temporary balloon is inserted and filled with saline to take up space in the stomach and promote a sense of fullness.
These procedures typically offer faster recovery, fewer risks, and can be effective tools for sustainable weight loss when combined with lifestyle and nutrition support.
Explore surgical options. For individuals with severe obesity, bariatric surgery may significantly reduce or even resolve GERD symptoms.
Get expert support at Hoag. Our physicians can:
- Help you understand the link between weight and GERD
- Create a personalized treatment plan
- Connect you with weight management programs, nutritionists, endoscopic, or surgical specialists
Get Support for Weight Management at Hoag
At Hoag, you don’t have to navigate this alone. Our physicians can help you understand the connection between your weight and GERD, create a personalized treatment plan, and offer referrals to weight management programs, nutrition experts, or surgical specialists if needed.
The relationship between obesity and GERD is strong, but it’s also manageable. With the right support, you can take steps to lose weight, reduce symptoms, and improve your overall well-being. If you’re struggling with acid reflux and want answers you can trust, schedule a consultation with a Hoag physician today.
