Gastroesophageal Reflux in Women Parallels Weight Gain

May 31, 2006

BOSTON - Symptoms of gastroesophageal reflux disease increase progressively with increasing body mass indices, even among normal-weight women, according to data from the Nurses' Health Study.

BOSTON, May 31 ? Symptoms of gastroesophageal reflux disease (GERD) increase progressively with increasing weight, even among normal-weight women, according to data from the Nurses' Health Study.

The risk of GERD symptoms rose across all categories of increasing body mass index (BMI) from normal weight to obese, Brian Jacobson, M.D., of Boston University, and colleagues, in the June 1 issue of the New England Journal of Medicine.

Even moderate weight gain among normal-weight persons may be associated with symptoms of reflux, they said. By contrast, weight loss was linked to a decrease in symptoms, These findings held for all degrees of severity and duration, as well as for nocturnal symptoms.

In 2000, the researchers used a supplemental questionnaire to determine the frequency, severity, and duration of GERD symptoms among randomly selected participants in the Nurses Health Study. BMI had been measured in 1998.

Of 10,545 women who completed the questionnaire, 2,310 (10%) reported having symptoms at least once a week, while 3,419 (55%) of those who had any symptoms described their symptoms as moderate in severity. Symptoms were defined as heartburn, acid regurgitation, or both.

After controlling for smoking, alcohol use, sphincter-pressure medications, and dietary habits, the researchers observed a dose-dependent relationship between increasing BMI and the frequency of reflux symptoms (multivariate P for trend

Among the study's limitations is that the data cannot provide a causative mechanism for the association, the researchers said. It is possible, they suggested, that a hormonal factor related to adiposity is more important in the development of GERD than are mechanical factors, "although probably multiple factors are responsible," they said.

Also, the investigators noted that because the study was limited to women, it was not possible to comment on the weight-reflux association in men.

The findings of this study, Dr. Jacobson and colleagues concluded, are of particular concern given recent U.S. trends of growing obesity in among both adults and children.