Obesity is a major risk factor for a range of serious medical conditions, including cardiovascular disease, pancreatitis, and liver disease, among many other conditions. All medical practitioners, including gastroenterologists, must remain aggressive about addressing and treating obesity in their patients. Although it may be premature to claim that weight loss can alleviate the symptoms of FGIDs, it is unlikely that weight loss will exacerbate these symptoms. Given the strength of the available evidence, it seems reasonable to tell patients that weight loss may modestly improve GERD and other symptoms, particularly diarrhea, and that this benefit is one of many that weight loss can provide.
Although the pathophysiology linking obesity to FGID-related symptoms is evolving, patients may benefit from a high-level understanding that weight loss may improve a range of abnormal eating behaviors, positively improve GI hormone levels, and potentially help regulate GI motility.
Although obesity is clearly linked to GERD, its relationship with Functional Gastrointestinal Disorders (FGIDs) & related GI symptoms remains tenuous. Obesity has an epidemiologic association with diarrhea, but it has inconsistent associations with other foregut symptoms (eg, nausea, bloating, upper abdominal pain) & hindgut symptoms (eg, constipation, lower abdominal pain). Moreover, it remains unclear whether these associations, however tenuous, imply causations. The available data indicate that weight loss may modestly improve both upper & lower abdominal GI symptoms, thus suggesting a potential causal link.
Although it may be premature to claim that weight loss can alleviate the symptoms of FGIDs, it is unlikely that weight loss will exacerbate these symptoms. Given the strength of the available evidence, it seems reasonable to tell patients that weight loss may modestly improve GERD & other symptoms, particularly diarrhea, & that this benefit is one of many that weight loss can provide.