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In Brief: Rising BMI increases reflux, even in normal-weight women

In Brief

Rising BMI increases reflux, even in normal-weight women

Women who put on a few pounds, even if their body mass index (BMI) remains normal, may be at increased risk for gastroesophageal reflux disease (GERD), according to a study conducted at the Harvard Medical School and Boston University School of Medicine. Past research has linked GERD to being overweight or obese, but this study — in the June 2, 2006, New England Journal of Medicine — is the first to suggest that it may result from weight gain in normal-weight people.

GERD arises when stomach contents flow back (reflux) into the esophagus due to a faulty valve at its lower end. Symptoms include heartburn (a burning or painful sensation behind the sternum) and regurgitation (the backflow of refluxed stomach contents into the back of the mouth). Occasional heartburn is generally not a problem, but frequent symptoms — more than twice a week — may be a sign of GERD. Untreated, it can have serious consequences, including esophageal cancer.

Drawing on data from 10,545 women in the Nurses Health Study, the researchers evaluated the relationship of GERD symptoms to changes in BMI. The researchers found that the risk of frequent GERD symptoms rose steadily with increasing BMI, even with BMIs in the normal range. Women with BMIs of 22.5–24.9 (upper part of the normal range) were nearly 40% more likely to have frequent GERD symptoms than women with BMIs of 20.0–22.4 (lower normal range). The risk was more than double for overweight women.

Researchers aren’t sure how extra weight affects GERD. It could be that the weight itself increases pressure on the stomach, pushing its contents up. Another idea is that hormones play a role, but a specific mechanism isn’t known.

The study also found that GERD was related more to percentage of body fat than to fat distribution.

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Last updated:	September 20, 2006