Obesity and GERD – A heavy load indeed
As per WHO reports, at least 2.8 million people die every year from being overweight or obese. According to revelations of a health study, more than 35% men and over 30% women in Dubai are overweight with a total 12% being obese. Obesity is on the rise in the UAE and also globally, studies report that the rate of obesity in UAE is double the world average.
This is a rather substantial issue in the UAE that only seems to be getting worse. Many point to the lifestyles in UAE as a major contributor of this health condition. Easily accessible fast foods, long working hours, lack of any physical activity etc. are leading contributors to the rising numbers. BMI or body mass index is the measure of obesity that is calculated using a person’s height and weight. A BMI of 20-25 is considered healthy, BMI greater than 25 is considered overweight and greater than 30 is considered obese. An obese individual may be more prone to major health issues like conditions of the heart, breathing problems, diabetes, knee and joint pains, difficulty in walking, GERD etc.
Studies now reflect that being even slightly overweight can increase the risk and severity of Gastro Esophageal Reflux Disease or GERD. This is reiterated by a study published in the New England Journal of Medicine, which states that relatively small changes in weight, even in a normal weight person can increase the severity of acid reflux and the symptoms associated with it. The study outlines a direct relation between the body mass index and GERD. The more the BMI, the more chances of a person to experience heartburn. The study also established that overweight individuals are twice as likely to develop GERD as compared to people with normal body weight and obese individuals are three times more likely to develop the condition.
GERD is a chronic condition in which contents of the stomach flow back into the esophagus resulting in symptoms such as heartburn, chest pain, bad breath, acidic taste in the mouth, breathing problems etc. Exposure of the esophagus to acid reflux for prolonged periods may also have long-term consequences like inflammation of the esophagus, narrowing or tightening of the esophagus causing difficulty in swallowing or Barrett’s esophagus. Obesity contributes to GERD in several ways. Simplest mechanism is probably by increasing intra-abdominal pressure, but there are perhaps hormonal mechanisms also that play a part. Choice of food is also important. Fatty foods tend to stay in stomach longer and have a higher probability to contribute to reflux. Avoiding fatty, acidic or spicy foods can help reduce symptoms to quite an extent. Exercise helps in many ways too.
When it comes to weighing treatment options, the most frequently asked question is what needs to be treated first, obesity or GERD. It is probably wise to tackle both simultaneously.
In the case of obese people who have multiple risks to their health, bariatric surgery can help loose excess amount of body weight and reduce associated morbidity. Surgery is an option that should be considered only after trying to reduce weight through traditional means first and if there is a very obvious threat to health and wellbeing of the patient.
It is crucial for people to understand the various means of treatment for both obesity and GERD and its consequences.
Obesity is the root cause for a number of health conditions and GERD is one of them. Treating obesity requires a multipronged approach involving several health professionals and disciplines.
Dr Amal Upadhyay
Aster Hospital Mankhool