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Purpose of Review <p>The rates of gastroesophageal reflux disease (GERD) and obesity have been increasing in parallel. Obesity contributes significantly to the development of GERD due to anatomical and physiological changes in the obese population. This review provides an overview of the diagnosis and management of GERD, with a particular focus on the unique considerations in the obese population including current strategies for weight loss, which is central to GERD treatment.</p> Recent Findings <p>Novel anti-obesity medications (AOMs), such as glucagon-like peptide-1 (GLP1) receptor agonists, have improved the medical management of weight loss, though it is important to consider the potential risks of worsening GERD and de-novo gastroparesis. Endoscopic gastric remodeling procedures can also assist with weight loss in select patients who may not qualify for bariatric surgery, and Roux-en-Y gastric bypass (RYGB) is the bariatric surgery of choice for GERD.</p> Summary <p>There should be a low threshold for patients with obesity who have esophageal symptoms to undergo a diagnostic workup given their increased risk of GERD-related complications (i.e., erosive esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma). Weight loss is key to the treatment of GERD in this population with various options now available such as lifestyle modifications, anti-obesity medications, and endoscopic or surgical interventions.</p>

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GERD Management in the Patient with Obesity: Diagnostic and Therapeutic Considerations

  • 期刊论文

  • 发表日期：

    2025年6月2日

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  • Anjali Bhatt,
  • Roma N. Ahuja,
  • Anh D. Nguyen

摘要

Purpose of Review

The rates of gastroesophageal reflux disease (GERD) and obesity have been increasing in parallel. Obesity contributes significantly to the development of GERD due to anatomical and physiological changes in the obese population. This review provides an overview of the diagnosis and management of GERD, with a particular focus on the unique considerations in the obese population including current strategies for weight loss, which is central to GERD treatment.

Recent Findings

Novel anti-obesity medications (AOMs), such as glucagon-like peptide-1 (GLP1) receptor agonists, have improved the medical management of weight loss, though it is important to consider the potential risks of worsening GERD and de-novo gastroparesis. Endoscopic gastric remodeling procedures can also assist with weight loss in select patients who may not qualify for bariatric surgery, and Roux-en-Y gastric bypass (RYGB) is the bariatric surgery of choice for GERD.

Summary

There should be a low threshold for patients with obesity who have esophageal symptoms to undergo a diagnostic workup given their increased risk of GERD-related complications (i.e., erosive esophagitis, Barrett’s esophagus, and esophageal adenocarcinoma). Weight loss is key to the treatment of GERD in this population with various options now available such as lifestyle modifications, anti-obesity medications, and endoscopic or surgical interventions.