Weighty Side of Heartburn
Losing weight is a popular New Year's
resolution that is often broken by February; however,
maintaining a healthy weight should be top of mind year round.
Alarmingly, recent data from the
Centers for Disease Control show that obesity has become an
epidemic — over 45 million adults are considered obese in the
U.S., with the percentage of overweight young people more than
doubling over the past 20 years.1 Individuals with a
Body Mass Index above 25 (see the
National Institute of Health's BMI Guidelines for
information) are considered to be overweight; those with a BMI
of 30 or above are considered to be obese.
Overweight individuals are more likely to
progress to obesity, which further heightens one's risk for
hypertension, type II diabetes, and other disorders including
Gastroesophageal Reflux Disease or GERD.2-4 One
large-scale analysis of more than 12,000 persons showed that
being overweight increased one's risk of being hospitalized for
GERD.5 However, despite research linking obesity with
GERD, the link between being overweight and having heartburn, an
often chronic and less severe precursor to GERD, is less well
Anecdotal evidence* has
associated heartburn with being overweight for some time, and in
actual practice this appears to be valid. According to nurse
practitioner Wendy L. Wright, MS, RN, from the Merrimack Village
Family Practice in New Hampshire, 61% of the U.S. population is
overweight (BMI ≥ 25), of which 20% to 30% of the children are
also overweight for their age-based ranges. For Wright, about
half of her patients (who are mostly female)* are
overweight, with roughly 35% of these persons experiencing
heartburn — about 18% in all. Similar proportions were noted
among patients seen by David A. Peura, MD, associate chief of
gastroenterology and hepatology at the University of Virginia
Health Sciences Center. Peura noted that roughly one-third of
his patients+ are overweight, and about half of these
have some degree of GERD — about 17%.
The saying "You are what you eat" is
doubly true for heartburn sufferers, noted Peura. Heartburn is
commonly caused by eating the wrong types of foods — those high
in fat content or acidity — and it can also occur as a result of
weight gain from overeating. Wright emphasized that small weight
changes can precipitate heartburn. For example, one patient she
treated began experiencing heartburn after gaining 12 pounds.
However, both Peura and Wright maintain that losing weight is a
factor in managing heartburn, and Peura noted that "heart
healthy diets are also
heartburn healthy, indicating that people can take control
of their heartburn and weight by adjusting their lifestyle. As
little as a 10% drop in weight can improve heartburn symptoms,
said Wright, a goal that is reasonably attainable. She
emphasized that many of her patients don't realize the
connection between heartburn and weight, saying that patients
should discuss any concerns about heartburn and/or weight with
their health care provider.
It should be noted that some studies have
shown that heartburn sufferers can continue to experience
symptoms even after an impressive weight loss. With this in
mind, heartburn sufferers should approach weight loss with the
goal of overall health benefits in mind, knowing that they may
experience the added benefit of improving heartburn symptoms.
Avoiding dietary fats, chocolate and
alcohol, combined with
routine exercise and reducing stress levels all lead to
improved heartburn symptoms, not to mention lost weight and a
healthier lifestyle. Although GERD cannot be treated with these
interventions, heartburn can. But, if heartburn symptoms
persist, see your health care provider. You can live up to your
New Year's resolution; it's not as weighty a task as it seems.
* The anecdotal
evidence presented is based on the experiences of NHBA Board
members Dr. David A. Peura and Nurse Practitioner Wendy L.
+ The findings
discussed here are for GERD sufferers only.
Physical Activity and Good Nutrition: Essential Elements to
Prevent Chronic Diseases and Obesity. (Accessed
12-16-02): National Center for Chronic Disease Prevention
and Health Promotion, 2002.
- Halsted CH. Obesity: effects on the
liver and gastrointestinal system. Curr Opin Clin Nutr
Metab Care 1999; 2:425-9.
- Barak N, Ehrenpreis ED, Harrison JR,
Sitrin MD. Gastro-oesophageal reflux disease in obesity:
pathophysiological and therapeutic considerations. Obes
Rev 2002; 3:9-15.
- Fisher BL, Pennathur A, Mutnick JL,
Little AG. Obesity correlates with gastroesophageal reflux.
Dig Dis Sci 1999; 44:2290-4.
- Ruhl CE, Everhart JE. Overweight, but
not high dietary fat intake, increases risk of
gastroesophageal reflux disease hospitalization: the NHANES
I Epidemiologic Followup Study. First National Health and
Nutrition Examination Survey. Ann Epidemiol 1999;