Table 2.
Links with gastro-oesophageal reflux |
Positive association between obesity and GORD in individual studies and meta-analyses |
BMI > 30 associated with double risk of GORD |
Increase in each BMI unit associated with increased risk of GORD |
Obesity associated with increased oesophageal acid exposure |
More acid reflux episodes in patients with obesity |
Reduction in GORD symptoms with weight loss |
Visceral adiposity independently associated with erosive oesophagitis and GORD symptoms |
Links with Barrett’s oesophagus |
Inconsistent association reported between overall measures of obesity and the prevalence of Barrett’s oesophagus |
Independent association between waist circumference and waist:hip ratio and Barrett’s oesophagus, more marked in men |
Inverse association between gluteofemoral obesity and Barrett’s oesophagus |
Positive association between visceral adipose tissue as assessed by CT scan and Barrett’s oesophagus |
Positive association between central obesity and risk of Barrett’s oesophagus reported in meta-analysis |
Links with oesophageal adenocarcinoma |
Obesity associated with increased risk of oesophageal adenocarcinoma |
Linear increase in adenocarcinoma risk with increasing BMI |
Increase in cancer risk with obesity independent of reflux symptoms |
Stronger association between increasing abdominal fat and risk of adenocarcinoma than other measures of obesity |
Increased visceral fat as shown on CT scan in patients with oesophageal adenocarcinoma compared with controls |
Inconsistent associations reported between obesity and oesophageal cancer survival |
BMI, body mass index; CT, computed tomography; GORD, gastro-oesophageal reflux disease.