Journal: Obesity Increases Risk of Serious Digestion Problems

Gastrointestinal diseases related to obesity raise serious health dangers, several of which are outlined in the August issue of The American Journal of Gastroenterology. The journal article examines the association between obesity and the risk of colorectal cancer and gastroesophageal reflux disease, or GERD.

Several studies featured in the article highlight the correlation between increasing body mass index (BMI) and the frequency and severity of acid reflux symptoms. One particular study found that accumulation of abdominal fat, as measured by the waist-to-hip ratio, may be the most important risk factor for the development of acid reflux and related complications such as Barrett’s esophagus and esophageal adenocarcinoma.

The study was done by Frank Friedenberg, MD, and colleagues from Temple University School of Medicine in Philadelphia. The findings provide an extensive overview of scientific research on the epidemiologic and pathophysiologic associations between obesity and GERD.

The authors also examined data on the effects of weight loss through diet or surgical methods on acid reflux disease. Several studies suggest that weight loss through caloric restriction was beneficial in reducing GERD symptoms.

When the authors compared the different surgical approaches for weight loss (a surgical technique called “Roux-en-Y”) gastric bypass appeared to be the best method, and was most consistently associated with improvement in the symptoms and findings of GERD.

In another study, high body mass index was found to increase risk for colorectal adenomas. Researchers at the University of Tokyo and Kameda General Hospital in Japan examined the effect of body weight on the incidence of colorectal adenoma in 7,963 Japanese patients who underwent colonoscopy between 1991 and 2003. Patients who had a family history of colorectal cancer, colorectal polyps, inflammatory bowel disease, colorectal surgery or who took NSAIDS were excluded from the study.

In this cross-sectional study, patients were classified into four groups according to their body mass index (BMI). Researchers found 20.7 percent of patients had at least one colorectal adenoma. As the BMI increased, so did the prevalence of colorectal adenomas.

In a separate cohort analysis, 2,568 patients from the initial study underwent a second colonoscopy after one year to compare the effect of body weight changes on the development of new colorectal adenomas. The incidence rates of colorectal adenoma were 9.3 percent in patients who lost 5 percent or more in body weight; 16.2 percent in patients who gained 5 percent or more in body weight; and 17.1 percent in patients who neither gained nor lost weight.

Weight loss was associated with lowered incidence of adenoma, independent of gender, age, initial colonoscopic findings, and initial BMI. Based on their findings, the authors suggest that controlling body weight may decrease the risk of developing colorectal adenomas.

Full text of the BMI and colorectal adenoma study is available here.

For full text of the GERD and obesity article, click here.