BACKGROUND There is a widespread notion that obesity leads to gastro-oesophageal reflux but scientific evidence of an association is limited and inconsistent.

AIMS To estimate the strength of the association between body mass and reflux symptoms, we performed a population based cross sectional interview study.

SUBJECTS Population based, randomly selected, middle aged or elderly persons in Sweden in 1995–1997.

RESULTS Reflux symptoms occurring at least once a week more than five years before the interview were reported by 135 (16%) of the 820 interviewees. Among those who had ever been overweight during adulthood (body mass index (BMI) ⩾25 kg/m²), the OR of having recurrent reflux symptoms was 0.99 (95% CI 0.66–1.47) compared with those who were never overweight. There was no association between BMI at age 20, BMI 20 years before the interview, or maximum adult BMI and occurrence of reflux symptoms: ORs per unit increase in BMI were 1.00 (95% CI 0.93–1.09), 1.03 (95% CI 0.96–1.10), and 1.01 (95% CI=0.95 1.07), respectively. There was no association between BMI and severity or duration of reflux symptoms.

CONCLUSIONS Gastro-oesophageal reflux symptoms occur independently of body mass index. Weight reduction may not be justifiable as an antireflux therapy.