People who are overweight or obese may be up to six times more likely to have Gastro Esophageal Reflux Disease (GERD) / Gastro Oesophageal Reflux Disease (GORD) than people who are of normal body weight.
The Scandinavian study outlining these findings appears in the July 2 issue of the Journal of the American Medical Association and was partially funded by AstraZeneca, the company that makes Prilosec, a GORD drug used in the US.
The association was strongest among heavy, premenopausal women and women who have used hormone therapy, suggesting that estrogen may play a role in the development of the stomach disorder.
Although the study does not prove a cause-and-effect relationship, the findings do appear to be significant.
“I was surprised by the strength of the associations,” says Dr. Magnus Nilsson, lead author of the paper and a consultant in the upper gastrointestinal surgery team at the Karolinska Institute in Stockholm, Sweden. “I definitely think that we have established a new and significant etiologic pathway in GERD. This is by far the largest study so far on reflux etiology.”
“It’s extremely well-designed and based on a very large population,” adds Dr. Ali Serdar Karakurum, chief of the division of gastroenterology at Nassau University Medical Center in East Meadow, N.Y. “We knew that the obesity and body mass index (BMI) and reflux association was there, but this actually showed that it was more striking than we ever knew.”
“The study reopens a very controversial issue, which has been a debate about the relation between obesity and reflux disease,” says Dr. David A. Johnson, chief of gastroenterology at Eastern Virginia School of Medicine in Norfolk and secretary of the American College of Gastroenterology. “It also reopens the issue about weight reduction as a potential facilitator of improvement of reflux symptoms, and it opens the question of use of hormonal therapy as potentially aggravating patients with reflux disease.”
This study compared 3,113 individuals who had symptoms of severe GERD with 39,872 people who did not have any symptoms of the disorder. All of the people had participated in a large public health survey in Norway between 1995 and 1997 and had completed a detailed, written questionnaire on symptoms of GERD, diseases, lifestyle factors, behavioral habits, work and employment information, medication use and more. Each participant also had a physical exam, including having their body weight, height and BMI measured.