Men’s Fitness Magazine recently ranked Houston as among one of the fattest cities in the United States. 34 % of Houstonians are overweight and the rates are rapidly rising for both adults and children. Overweight individuals have 3 times the likelihood of frequent GERD symptoms compared with those of normal weight. Studies have shown that the frequency of reflux symptoms is directly related to body mass index, BMI. The higher the BMI, which is your weight relative to your height, the more likely a person is to experience heartburn more than once a week. When tested for GERD by reflux experts, using a pH study, 70% of obese individuals (BMI more than 30) tested positive for acid reflux.
Overweight individuals (BMI between 25 and 30) who suffer from GERD will greatly benefit from lifestyle changes that result in weight loss. Portion control is the first key step in alleviating reflux symptoms. We tend to overeat and by doing so we distend our stomach and put too much pressure on the lower esophageal sphincter. The lower esophageal sphincter is a barrier between the esophagus and the stomach that prevents acid back up into the esophagus. Try smaller, more frequent meals to prevent stomach distention and preserve the lower esophageal sphincter function. Second, try to exercise on a daily basis to shed some of the extra weight you are carrying in the abdomen. Belly fat puts lot of pressure on the lower esophageal sphincter leading to acid reflux. Third, avoid eating greasy and fried food items. Food rich in fat delays emptying of your stomach content and increases the incidence of acid reflux. Make healthy choices that have a lower likelihood of triggering acid reflux such as fresh fruits, vegetables, lean meats, fish, and skinless poultry. Fourth, avoid carbonated beverages that contribute to stomach distention and add inches to your waist.
Obese GERD individuals (BMI above 30) are a sub group of patients were lifestyle changes tend not to be very effective in alleviating acid reflux. In this particular patient population, the decision often comes down to whether they are willing to undergo bariatric or weight loss surgery. Weight loss surgery has proved itself to be a long-term tool for obese patients to loose excess body weight and help control a number of concomitant health problems like diabetes, high blood pressure and GERD. I strongly recommend weight loss surgery as an effective and durable modality for patients suffering from GERD whose BMI is above 30.