If you’ve experienced heartburn on a regular basis, there’s a chance your healthcare provider has recommended losing weight. But why? What is the connection between that burning sensation in your chest and your body weight? This article will provide you with more information about the relationship between heartburn and weight gain as well as what you can do about it.

What is heartburn?

Heartburn is an uncomfortable burning sensation in your chest, typically felt behind the breastbone, but sometimes extending all the way up to the neck and throat. The pain is often worse when bending over or lying down and typically occurs after eating a meal. Heartburn happens as a result of acidic stomach contents coming back up into the esophagus (the tube that carries food from the mouth to the stomach) and irritating its lining.

Medical conditions that are associated with heartburn include:

• Gastroesophageal reflux disease (GERD)
• Pregnancy
• Hiatal hernia (when the upper part of the stomach comes up into the chest)

The terms GERD and acid reflux are frequently used interchangeably with heartburn, but they’re not the same. Most people at some point in their lives will experience heartburn, but that doesn’t necessarily mean they have GERD. Heartburn is a symptom of GERD and acid reflux is the reason why patients have heartburn and GERD. When heartburn happens frequently (two or more times per week), you may be diagnosed with GERD, but heartburn isn’t the only symptom of GERD. Some people with GERD experience coughing, throat clearing, hoarseness, difficulty swallowing, and/or a sensation that they have a lump in their throat. It has been found that GERD (chronic acid reflex) is a chronic condition that affects 20% of Americans. 

Heartburn is often brought on by certain foods and beverages such as spicy foods, chocolate, tomato-based products, peppermint, and caffeinated or alcoholic beverages. Tobacco use and weight gain are also risk factors for heartburn and GERD.

What’s the connection between heartburn and body weight?

According to the American College of Gastroenterology, “excess abdominal fat is one of the biggest risk factors for heartburn”. The reason for this is largely due to increasing abdominal pressure with weight gain. When you gain weight, particularly in the central abdominal area, there is increased pressure around the stomach which can push stomach contents back up into the esophagus, causing heartburn.

A hiatal hernia is also frequently associated with excess body weight. This is a condition where the upper portion of the stomach has come up into the chest cavity. Acid reflux is a common symptom of a hiatal hernia.

Heartburn treatment and weight management

If you’re experiencing heartburn symptoms, there are a number of things you can do to get relief. Many of these options can be done on your own, however, frequent or persistent heartburn should always be evaluated by a healthcare provider to assess what medical treatments could be best for you. If frequent heartburn persists untreated it can be a risk factor for serious conditions including esophageal ulcers and cancer. Treatment options for heartburn include lifestyle modifications, medications, and weight loss as described below:

Lifestyle modifications

• Avoid foods that trigger heartburn. This can vary from person to person, so finding your particular triggers is important. Common foods that increase the risk of heartburn include spicy foods, fatty foods, acidic foods such as tomato-based products, chocolate, onions, garlic, citrus foods, and peppermint.

• Don’t forget about beverages. For some people, alcohol, caffeine, and carbonated beverages can lead to heartburn – avoiding these can also be helpful.

• Wait at least 3 hours after eating to lay down. When laying down, it is easier for acid to come back up into the esophagus and cause heartburn. Waiting allows enough time for your food to digest and reduce the potential for this. If you have symptoms in the night regardless of meal timing, try elevating the head of your bed or using additional pillows to prop your head up while sleeping.

• Stop smoking. Tobacco use weakens the muscular valve at the bottom of the esophagus that keeps stomach contents out, so this increases the likelihood of acid reflux and heartburn. Quitting smoking is important for your health for a number of reasons and it can also help to reduce the frequency of heartburn.

Medications

• Antacids work by neutralizing stomach acid. These include over-the-counter products such as Tums^Ⓡ, Rolaids^Ⓡ, Alka-Seltzer^Ⓡ, and Mylanta^Ⓡ, which are typically taken after symptoms are noticed.

• Histamine-2 (H2) Blockers reduce the amount of acid produced by the stomach. These can be obtained both over-the-counter and by prescription depending on the dose. Common H2 blockers include cimetidine (Tagamet HB 200^Ⓡ) and famotidine (Pepcid^Ⓡ, Pepcid AC^Ⓡ). These medications work quickly, so they can be taken at symptom onset or used for prevention.

• Proton pump inhibitors (PPIs) also reduce the amount of acid produced by the stomach. These medications work very well but their effect on heartburn is less immediate, so they are typically used daily for prevention in people who have frequent and more severe symptoms. They can be obtained both over-the-counter and by prescription. Some common PPIs include omeprazole (Prilosec^Ⓡ), esomeprazole (Nexium^Ⓡ), lansoprazole (Prevacid^Ⓡ), and pantoprazole (Protonix^Ⓡ).

Some people have concerns about whether or not PPIs can cause weight gain. There is very limited evidence to suggest that this happens, so it should not be a reason for avoiding treatment if a proton pump inhibitor has been recommended for you.

Weight loss

If you have excess body weight and frequent heartburn, losing weight is one of the best things you can do to treat your symptoms. One study showed that 80% of persons who lost weight experienced improvement in GERD symptoms with more weight loss leading to less frequent symptoms. The same study showed that 65% of patients even had complete resolution of their GERD with weight loss. 

When it comes to losing excess weight to improve heartburn, there is no best diet, although it can be helpful to try to minimize those trigger foods that you’ve identified to be frequently causing your heartburn while also reducing calorie intake. Following a healthful, reduced calorie diet and increasing physical activity are the foundations of weight loss. If you’ve been doing that consistently and are not having success, it may be time to seek medical advice from a healthcare professional. Participating in a structured weight loss program can increase your success in losing excess body weight and relieving acid reflux symptoms. 

How the Form Health medical approach to weight loss can help you

If you are facing health issues related to excess weight, Form Health’s holistic approach to weight loss may be the right solution for you. At Form, your Board Certified Doctor and Registered Dietitian can help you navigate existing health conditions so you can reach your weight loss goals. Form uses physical activity, mindset shifts, nutrition and FDA-approved medication, if appropriate, as tools to create a personalized program for you based on your medical history and lifestyle.

Questions about medical weight loss? Schedule a free call with an enrollment specialist to learn more. Or take our quiz to find out if you’re a candidate today.

Tums^Ⓡ is a registered trademark of Glaxosmithkline Consumer Healthcare (US) IP LLC

Rolaids^Ⓡ is a registered trademark of Sanofi Consumer Healthcare

Alka-Seltzer^Ⓡ is a registered trademark of Bayer Healthcare, LLC

Mylanta^Ⓡ, Pepcid^Ⓡ and Pepcid AC^Ⓡ are registered trademarks of Johnson & Johnson

Tagamet HB 200^Ⓡ is a registered trademark of SmithKline Beecham Pharmaceuticals Co

Prilosec^Ⓡ and Nexium^Ⓡ are registered trademarks of AstraZeneca

Prevacid^Ⓡ is a registered trademark of Takeda Pharmaceuticals USA, IncProtonix^Ⓡ is a registered trademark of Wyeth Pharmaceuticals LLC, a subsidiary of Pfizer, Inc