A wide variety of pieces of evidence has suggested that
obesity is associated with a significant increase in the risk for
gastroesophageal reflux disease (
GERD) symptoms and its complications. The aim of this study was to evaluate the effect of
weight loss on reflux symptoms in
overweight/obese patients with proven
GERD. We enrolled
overweight/obese patients with typical
GERD symptoms and erosive
esophagitis. At baseline, patients underwent detailed reflux symptoms evaluation and anthropometric assessment, and were divided into two treatment groups: group A received
proton pump inhibitor (PPI) and a personalized hypocaloric diet and aerobic exercise; and group B received PPI and a 'standard of care diet'. The dietetic treatment was considered effective if at least 10% of
weight loss was achieved within 6 months. All patients were evaluated in terms of anthropometric data,
GERD symptoms, and PPI use. In group A, mean body mass index (BMI) decreased from 30.3 ± 4.1 to 25.7 ± 3.1 (P < 0.05), and mean weight decreased from 82.1 ± 16.9 kg to 69.9 ± 14.4 kg (P < 0.05). In group B, there was no change in BMI and weight. Symptom perception decreased (P < 0.05) in both groups during PPI
therapy, but a higher improvement was recorded in group A. In group A, PPI
therapy was completely discontinued in 27/50 of the patients, and halved in 16/50. Only 7/50 continued the same PPI dosage. In group B, 22/51 halved the
therapy and 29/51 maintained full dosage of
therapy, but none was able to discontinue PPI due to a symptom recurrence. Overall,
weight loss of at least 10% is recommended in all patients with
GERD in order to boost the effect of PPI on reflux symptom relief and to reduce chronic medication use.