Weight Loss Reduces Gastric Reflux Symptoms

After ringing in the New Year, Americans from all walks of life have started dieting. For the 10% to 20% of Americans who experience gastric reflux, such weight loss may be the key to reducing associated symptoms.

That’s the message from a study published on December 17, 2014, ahead of print in Diseases of the Esophagus. The authors designed it based on evidence linking obesity to a significant increase in the risk for gastroesophageal reflux disease (GERD) symptoms and its complications. Now, they have indicated that losing weight can reduce reflux symptoms in overweight/obese patients with proven GERD.

The researchers enrolled 102 overweight or obese adults with typical GERD symptoms and erosive esophagitis. After evaluating reflux symptoms and gathering anthropometric measurements, the researchers designated 2 treatment groups.

Group A received proton pump inhibitor (PPI) therapy and a personalized, low-fat, high-carbohydrate, hypocaloric diet and aerobic exercise. In this group, the goal was to achieve weight loss of at least 10% within 6 months. Group B received PPI treatment and a standard diet prescribed for GERD patients that advised about the types of foods to avoid, but there was no change in caloric intake.

Subjects in group A increased their exercise, walking an average of 11,342.8 steps per day as measured by a pedometer. They lost an average of 5.3 points of mean body mass index (BMI) and 12.2 kg of weight. In contrast, subjects in group B maintained both their BMI and weight.

Although patients in both groups perceived fewer symptoms during PPI therapy, subjects in group A reported significantly greater improvements, and more than half of them completely discontinued PPI treatment. An additional one-quarter of group A patients halved their PPI doses.

In group B, 43% of subjects halved their PPI therapy, and 57% maintained full-dose PPIs. However, none of them discontinued PPI therapy.

The authors recommended weight loss of at least 10% in all patients with GERD to boost the effect of PPI on reflux symptom relief and reduce chronic medication use.