Gastroesophageal reflux in obese patients is not reduced by weight reduction

Background: The present study tested the hypothesis that weight reduction improves the subjective and objective manifestations of gastroesophageal reflux. Methods: Twenty obese patients with gastroesophageal reflux as shown by 24-h pH measurement and with symptoms requiring daily medication were studied. The patients were randomized into a group (A) treated with very low-caloric diet (VLCD) and a control group (B). Objective measurements were repeated after 6 months. Group B was then treated with VLCD and reexamined. Results: Patients in group A lost 10.8 +/- 1.4 kg whereas group B gained 0.6 +/- 0.7 kg (P < 0.001). There was no reduction in reflux according to pH measurement. Furthermore, there were no significant changes in reflux symptoms. After VLCD treatment, group B lost 9.7 +/- 1.6 kg, but reflux indicators remained unchanged. All patients except one in group B remained dependent on daily anti-reflux medication. Conclusion: Weight reduction does not improve the subjective or objective manifestations of reflux.