Obesity satisfies several criteria for a causal association with GORD and its complications including generally consistent association and some dose–response relationship. Abdominal obesity seems to explain a considerable part of this association operating mostly by increasing intragastric pressure, gastroesophageal gradient, TLOSR, and oesophageal acid exposure. Additional humoral mechanisms may be important in Barrett’s oesophagus and oesophageal adenocarcinoma but this remains poorly examined. Maintaining normal weight may reduce the likelihood of developing GORD and its potential complications.
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Competing interests: None
Funding: Dr H El-Serag is supported by NIH grant ROI CA 116845-01A2.