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Weight Loss May Reduce GERD Problems

Breaking News - August 2005 - Week 3

(Aug 17, 2005)

Healthcare in  the News

-- Being overweight can contribute to symptoms of gastroesophageal reflux disorder, commonly known as GERD, according to a report in the Annals of Internal Medicine.

Picture of a woman looking at a computer screen, holding a cup

In a meta-analysis, which is a review of several studies, investigators found that excess weight nearly doubled the risk of GERD symptoms such as heartburn, acid regurgitation, chest pain, and difficulty swallowing.

People who were obese, defined as a body mass index (BMI) greater than 30, were nearly three times more likely to develop esophageal cancer than those with a healthy body weight.

BMI is a measure of a person's weight in relation to his/her height.

GERD occurs when the valve between the stomach and the esophagus fails to close properly. As a result, the contents in the stomach, including stomach acid, can spill up into the esophagus, leading to erosion of the esophagus and, in some cases, esophageal cancer.

The results point to a way to prevent and treat both GERD and its associated complications, says Dr. Hashem B. El-Serag, a study author. He adds that an important next step will be to investigate whether weight loss actually improves GERD symptoms and complications.

Obesity Associated with GERD

"There is credible evidence to incriminate obesity in yet another set of diseases," he says. "Although there is little information on whether losing weight will reverse the risk of these complications, it is very likely that staying [at a] normal weight helps reduce the risk of GERD and its complications."

Dr. David A. Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School, agrees, noting that weight loss has been shown to improve a number of other medical problems.

"The causal relationship is there and it would be suggestive that reduction in obesity and overweight status would be helpful for lots of reasons," Dr. Johnson notes.

The new study findings come in the context of a steady rise in both obesity and the complications of GERD in the US and Western Europe. Nearly two-thirds of American adults are overweight, according to the Centers for Disease Control and Prevention (CDC).

At the same time, the rate of esophageal adenocarcinoma has quadrupled in the past 20 years with an estimated 20 percent of US adults suffering from GERD, the study authors report.

Abdominal Obesity a Culprit

But exactly how excess body weight increases GERD symptoms and complications remains unclear. One possibility is that too much weight in the abdomen compresses the stomach and raises the pressure inside, leading to gastric reflux.

Alternately, abdominal obesity can contribute to the release of inflammatory substances that may raise the risk of GERD.

Thirdly, many persons who are obese eat excessive amounts of fat, and fatty foods can increase the risk of GERD, explains Dr. El-Serag, assistant professor of medicine at Baylor College of Medicine in Houston.

The study results are based on an analysis of nine studies conducted over 18 years. People who were overweight, defined by a body mass index of 25 to 30, were 1.4 times as likely to develop GERD symptoms, while people who were obese were nearly twice as likely to develop symptoms compared to those with a healthy body weight.

The study "adds another reason for patients to remain a healthy weight," Dr. El-Serag says. "This can help them avoid GERD with its associated nuisance, treatment, and potential complications, including cancer of the esophagus.

Always consult your physician for more information.

For more information on health and wellness, please visit health information modules on this Web site.

Facts about Obesity

The US Surgeon General has declared that overweight and obesity have reached epidemic proportions in this country.

One in three US adults are overweight or obese and 15 percent of children between the ages of six and 19 are overweight.

Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health.

Currently, about 35 percent of women and 31 percent of men are considered seriously overweight. Obesity is a serious, chronic disease that can inflict substantial harm to a person’s health.

Overweight and obesity are not the same; rather, they are different points on a continuum of weight ranging from being underweight to being morbidly obese.

The percentage of people who fit into these two categories, overweight and obese, is determined by Body Mass Index (BMI).

BMI is a measure of weight proportionate to height. BMI is considered a useful measurement of the amount of body fat.

Occasionally, some very muscular people may have a BMI in the overweight range.

However, these people are not considered overweight because muscle tissue weighs more than fat tissue.

Generally, BMI can be considered an effective way to evaluate whether a person is overweight or obese.

According to the National Heart, Lung, and Blood Institute (NHLBI), a BMI from 18.5 to 24.9 is considered normal while a BMI of more than 25 is considered overweight.

A person is considered obese if the BMI is greater than 30 and morbidly obese if the BMI is 40 or greater.

In general, after the age of 50, a man’s weight stabilizes and even drops slightly between the ages of 60 and 74.

However, a woman’s weight continues to increase until age 60 and then begins to drop.

Another measure of obesity is the waist-to-hip ratio (WHR). The WHR is a measurement tool that looks at the proportion of fat stored on the waist, and hips and buttocks.

The waist circumference indicates abdominal fat.

A waist circumference over 40 inches in men and over 35 inches in women may increase the risk for heart disease and other diseases associated with being overweight.

Consult your physician with questions regarding healthy body weight.

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