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Digestive Disorders

2004 Edition

New Research:
Obesity Increases the Risk of Reflux

People who are obese, especially women, have an increased risk of gastroesophageal reflux
symptoms like heartburn and regurgitation.

According to a new study, severely obese men (i.e., a body mass index [BMI] of greater than 35) have a three times greater risk of reflux symptoms than men with a normal body mass (a BMI of less than 25). Severely obese women have six times the risk of reflux symptoms. Also, severely obese premenopausal women are much more likely to have reflux symptoms than severely obese postmenopausal women, suggesting that female sex hormones may play a role in the relationship between obesity and reflux.

These results were based on a 1995 to 1997 survey of 65,363 Norwegians. Many of these individuals also participated in an earlier (1984 to 1986) survey of 74,599 Norwegians. People who lost weight between the first and second survey were less likely to have reflux symptoms at the second survey than those who did not lose weight, indicating that weight loss can reduce the risk of reflux.

Obese premenopausal women are likely to have higher levels of active estrogen, which the researchers hypothesize may increase the synthesis of nitric oxide. Nitric oxide might lead to reflux by relaxing the smooth muscle in the lower esophageal sphincter.

Journal of the American Medical Association
Volume 290, page 66
July 2, 2003


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Digestive Disorders

The Digestive Disorders White Paper from The Johns Hopkins White Papers series is an annual, in-depth report written by Hopkins physicians.



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