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Last updated: Aug 04, 2022
5 min read

Acid reflux and weight loss: what’s the connection?  

 

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Acid reflux—also known as acid indigestion or heartburn—can cause discomfort that impacts what you eat and how much. These changes in diet can lead to unintentional weight loss. On the other hand, being overweight can lead to acid reflux. Here’s what to know about the relationship between acid reflux and weight loss. 

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Relationship between acid reflux and weight loss

Studies show carrying excess weight boosts the risk of acid reflux. However, if symptoms of acid reflux become so uncomfortable that you limit what you eat, acid reflux can also lead to weight loss. If you have acid reflux, you may relate to not wanting to add to the discomfort.

Acid reflux or gastroesophageal reflux (GER) occurs when the contents of your stomach rise into your esophagus—the tube where food goes down. This happens when the sphincter muscle at the bottom of the esophagus that closes off the stomach is weakened or under pressure. This can allow stomach acid to flow upwards. Not everyone notices symptoms of GER. However, GER can cause a variety of reflux symptoms, such as (NIDDK, 2020): 

  • Bitter taste in the mouth
  • Heartburn (chest pain with burning sensation)
  • Regurgitation
  • Belching
  • Nausea

An estimated 20% of Americans suffer from chronic acid reflux, known as gastroesophageal reflux disease (GERD). In more severe cases, GERD can damage the lining of the esophagus. Symptoms of more severe GERD include (Antunes, 2022; NIDDK, 2020):

  • Sore throat or hoarse voice 
  • Dry cough
  • Feeling like there is a lump in the throat
  • Difficulty swallowing
  • Erosion of tooth enamel
  • Vomiting 
  • Weight loss
  • Bleeding in the digestive tract (tar-like stool, vomit that looks like coffee grounds)
  • Changes in the surface of the esophagus

A complication called Barrett’s esophagus can occur in up to 15% of those with GERD symptoms. With this condition, stomach acids change the skin cells in the esophagus to resemble those in the intestine. The changes can sometimes lead to esophageal cancer (Khieu, 2022).

Risk factors for GERD

Weight, especially around the waist, can put pressure on the stomach and the muscles that keep its contents in place. This makes acid more likely to rise into the esophagus (Antunes, 2022).

Excess weight is among the common risk factors for GERD, which include (Antunes, 2022; NIDDK, 2020):

  • Obesity or overweight 
  • Pregnancy
  • Hiatal hernia (stomach pushes up through the lining above)
  • Abnormalities in the valve muscles that keep stomach contents in place
  • Delayed emptying of the stomach
  • Some medications and supplements (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs], antihistamines, statins, steroids, nitrates, calcium channel blockers, glucagon, benzodiazepines, vitamin C ) (MacFarlane, 2018)
  • Smoking (Ness-Jensen, 2017).
  • Poor posture
  • Tight clothing
  • Eating large meals or eating too fast

Does losing weight help GERD?

Yes. In cases where weight gain is a contributing factor, weight loss has been shown to help reduce or even eliminate the severe symptoms of GERD (Singh, 2013). In fact, weight loss is among the lifestyle approaches that are the basis of treating GERD. These also include (Azer, 2022; NIDDK, 2020):

  • Avoid large meals. Frequent meals and smaller meals reduce stomach acid and pressure.
  • Avoid meals at least 3 hours before bedtime. Laying down makes it easier for stomach acids to travel upwards.
  • Elevate the head of the bed 8 inches at an even incline (tilted bed or wedge pillow).
  • Improve sleep. Uninterrupted sleep reduces the risk of GERD.
  • Quit smoking.
  • Avoid foods that trigger acid reflux. Common triggers are a high-fat diet, spicy or fried foods, citrus and tomato products, carbonated beverages, and alcohol (Heidarzadeh-Esfahani, 2021).

Over-the-counter (OTC) medications like antacids (e.g., Tums, Rolaids, Mylanta) or histamine-2 (H2) blockers (e.g., Pepcid, Zantac, Tagamet), neutralize or reduce stomach acids. Stronger medications called proton pump inhibitors (PPIs) more fully block stomach acid production. Some like Prilosec (omeprazole) and Nexium (esomeprazole) come in both prescription and OTC versions, while others like Protonix (pantoprazole) can only be prescribed (FDA, 2021). 

PPIs are often used for short amounts of time or only when needed to avoid potential long-term side effects. As with any medication, it’s important to talk to your doctor about the risks, benefits, and whether a PPI may interact with your other medications. If you’re pregnant or breastfeeding, speak to your healthcare provider before taking PPIs (FDA, 2021; MedlinePlus, 2021).

Bariatric surgery—including some minimally invasive techniques—may be an option for those with severe GERD that is not responding to lifestyle changes or medications (Antunes, 2022).

Does GERD cause weight loss?

If you suffer from chronic acid reflux and it goes untreated, you may unintentionally lose weight. This type of acid reflux weight loss can happen if heartburn symptoms cause you to eat less or avoid certain foods. GERD symptoms like nausea or painful swallowing can lead to the loss of appetite or make it difficult to eat (NIDDK, 2020).

Being underweight is linked to serious health problems, especially in older people. Studies have shown those who are underweight have a higher risk of death and cardiovascular disease (Lorem, 2017; Park, 2017).

When to call a healthcare provider

If you experience acid reflux, it’s best to contact your healthcare provider, especially if you begin to notice it more frequently. There could be a specific cause, such as a medication or a dietary change. A complete overview of symptoms can also help rule out any other conditions. 

Based on your symptoms, you may get a diagnosis of GER or GERD. Depending on the severity, your primary care physician may refer you to a healthcare provider who is trained in gastroenterology. These providers specialize in treating digestive health conditions and preventing complications. 

Keep in mind that what works for some people may not work for others. If you experience acid reflux, it’s best to work with a healthcare provider to come up with a tailored treatment approach that pinpoints what’s causing your symptoms and includes lifestyle and dietary changes, if needed. 

References

  1. Antunes, C., Aleem, A., & Curtis, S. (2022). Gastroesophageal reflux disease. StatPearls. Retrieved on July 17, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK441938/ 
  2. Azer, S. A. & Reddivari, A. K. R. (2022). Reflux esophagitis. StatPearls. Retrieved on July 17, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK554462/
  3. Ha, J. O., Lee, T. H., Lee, C. W., et al. (2016). Prevalence and risk factors of gastroesophageal reflux disease in patients with type 2 diabetes mellitus. Diabetes & Metabolism Journal, 40(4), 297–307. doi.10.4093/dmj.2016.40.4.297. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27352149/ 
  4. Heidarzadeh-Esfahani, N., Soleimani, D., Hajiahmadi, et al. (2021). Dietary intake in relation to the risk of reflux disease: A systematic review. Preventive Nutrition and Food Science, 26(4), 367–379. doi:10.3746/pnf.2021.26.4.367.  Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8747955/ 
  5. Khieu, M. & Mukherjee, S. (2022). Barrett esophagus. StatPearls. Retrieved on July 17, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK430979/
  6. Lorem, G. F., Schirmer, H., & Emaus, N. (2017) What is the impact of underweight on self-reported health trajectories and mortality rates: a cohort study. Health and Quality of Life Outcomes, 15(1), 191. doi:10.1186/s12955-017-0766-x. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625617/
  7. MacFarlane, B. (2018) Management of gastroesophageal reflux disease in adults: a pharmacist’s perspective. Integrated Pharmacy Research and Practice, 7, 41–52. doi:10.2147/IPRP.S142932. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993040/ 
  8. MedlinePlus. (2021). U.S. proton pump inhibitors: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/patientinstructions/000381.htm
  9. Ness-Jensen, E. & Lagergren, J. (2017). Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. Best Practice & Research Clinical Gastroenterology.  Retrieved from https://pubmed.ncbi.nlm.nih.gov/29195669/ 
  10. Park, D., Lee, J. H., & Han S. (2017) Underweight: another risk factor for cardiovascular disease?: A cross-sectional 2013 Behavioral Risk Factor Surveillance System (BRFSS) study of 491,773 individuals in the USA. Medicine (Baltimore), 96(48), e8769. doi:10.1097/MD.0000000000008769. Retrieved from  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728753/ 
  11. Singh, M., Lee, J., Gupta, N., et al. (2013). Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: A prospective intervention trial. Obesity (Silver Spring, MD), 21(2), 284–290. doi:10.1002/oby.20279. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853378/ 
  12. U.S. Department of Health and Human Services. (2020). Acid reflux (ger & gerd) in adults. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
  13. U.S. Food and Drug Administration (FDA). (2021) Over-the-counter (OTC) heartburn treatment. Retrieved from https://www.fda.gov/drugs/information-consumers-and-patients-drugs/over-counter-otc-heartburn-treatment