Weight Loss Can Lead to Resolution of Gastroesophageal Reflux Disease Symptoms: A Prospective Intervention Trial

Abstract

Objective-Weight gain is an important risk factor for gastroesophageal reflux disease (GERD); however, whether weight loss can lead to resolution of GERD symptoms is not clear. Our aim was to measure the impact of weight loss on GERD symptoms.Design and Methods-In a prospective cohort study at a tertiary referral center, overweight/ obese subjects (BMI 25-39.9 kg/m2) were enrolled in a structured weight loss program. Weight loss strategies included dietary modifications, increased physical activity and behavioral changes. At baseline and at 6 months, BMI and waist circumference were measured and all participants completed a validated reflux disease questionnaire.Results-A total of 332 adult subjects, mean age 46 years and 66% women were prospectively enrolled. At baseline, the mean body weight, BMI, and waist circumference were 101 (±18) kg, 35 (±5) kg/m2 and 103 (±13) cm. At 6 months, majority of the subjects (97%) lost weight (average weight loss: 13 ± 7.7 kg) and as compared with baseline, there was a significant decrease in the overall prevalence of GERD (15 vs. 37%; P < 0.01) and the mean GERD symptom score (1.8 vs. 5.5; P < 0.01). Overall, 81% of the subjects had reduction in GERD symptom scores; 65% had complete resolution and 15% had partial resolution of reflux symptoms. There was a significant correlation between % body weight loss and reduction in GERD symptom scores (r = 0.17, P < 0.05).Conclusions-In conclusion, the overall prevalence of GERD symptoms is high (37%) in overweight and obese subjects. A structured weight loss program can lead to complete resolution of GERD symptoms in the majority of these subjects.

Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups

“…In addition, the decreased BMI was associated with successful treatment with anti‐reflux medication. In a prospective cohort study of 332 obese adults enrolled in a weight loss program, a mean weight loss of 13 kg was observed, and there was significant decrease in the prevalence of GERD (15% vs 37%, P <.01) and the mean GERD symptom score (1.8 vs 5.5, P <.01) . Conversely, a relatively smaller study comprising obese patients (n=20) showed no significant changes in reflux symptoms after the loss of an average of 10.8 kg of weight, and another population‐based study (n=637) found no relation between weight loss and change in GERD symptoms …”

“…Thus, recent studies have investigated the association between changes in weight or WC and GERD, and have shown that weight gain or increase in WC is positively associated with the development of GERD symptoms or erosive esophagitis . However, there has been relatively little focus on the effect of weight loss or decrease in WC on improvement of GERD symptoms or erosive esophagitis . This study aimed to evaluate the association of weight loss or decrease in WC with GERD symptoms and erosive esophagitis in a large health‐screening cohort.…”

Obesity

“…The substantial weight loss associated with bariatric surgery has been shown to improve asthma with a 48%–100% improvement in symptoms and reduction in medication use (Juel, Ali, Nilas, & Ulrik, ); however, there is a potential threshold effect so that modest weight loss of 5%–10% may lead to clinical improvement (Lv, Xiao, & Ma, ). Similarly, modest weight loss of 5%–10% improves GERD (Singh et al., ) and liver function (Haufe et al., ). A study utilizing MRI scanning to examine the effects of weight loss on NAFLD has reported a reduction in liver fat from 18.3% to 13.6% ( p = .03), a relative reduction of 25% (Patel et al., ).…”

Gastroesophageal reflux disease in the obese

“…Overall, 81% of the subjects had reduction in GERD symptom scores and 65% had complete resolution. Furthermore, there was a significant correlation between percent weight loss and reduction in GERD symptom scores (26). In a study of contributing lifestyle measures, weight loss and head of the bed elevations were the two interventions with supporting evidence of benefit.…”