Obesity

Obesity continues to be a serious national health problem. Despite greater media attention, the problem has been getting worse for the past 20 years. There has been a large increase in the number of overweight and obese people in the U.S. since the 1980s.

A person is considered overweight if his or her body mass index, a measure of weight adjusted for height, is between 25 and 29.9. A person is considered obese if his or her BMI is 30 or greater. Both "overweight" and "obesity" carry health risks, including diabetes, heart disease, high blood pressure, certain types of cancer, and gallbladder disease. Specific GI disorders that are affected by obesity include:

Gallstones

Although you don't have to be overweight to have gallbladder disease, people who are overweight face a risk three times greater than people of average weight. The precise reason why being overweight causes gallstones is unclear. Scientists believe that being overweight leads to gallstone formation both because of excess cholesterol production (which upsets the balance in the bile) and because obesity decreases the gallbladder's ability to contract. Even a moderate amount of overweight increases one's risk of developing gallstones.

Ironically, rapid weight loss also increases the risk of developing gallstones. The mechanisms that cause stones to form during weight loss are similar to weight gain, although the tendency to develop stones is only temporary with weight loss. Dieting alters the cholesterol-bile salt balance in favor of gallstone formation, and skipping meals decreases the contractions of the gallbladder. Rapid or extreme weight loss seems to increase the risk of gallstones. If you need to lose weight, do it gradually; and if you already suffer from gallstones, see your doctor before starting on a weight-loss program.

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Heartburn Caused by Acid Reflux

Being overweight can worsen the symptoms of acid reflux, what doctors call gastroesophageal reflux disease (GERD). Losing weight can help to reduce the frequency or severity of GERD symptoms. The theory is that excessive pressure in the area of the stomach or abdomen can "push" stomach contents back up into the esophagus. This is especially true for people who carry their weight more around their waist than their hips (the so-called "apple" rather than "pear" shape). When people of this shape wear tight-waisted clothing and do heavy lifting or straining, this can result in enough increased pressure to trigger heartburn.

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Cancers Of The GI Tract

There seems to be some association of obesity and increased risk of certain cancers of the GI tract, including colon and gallbladder cancer. However, a reason for this association has not been clearly identified by medical researchers. Other cancers, such as breast and uterine cancer, clearly occur more often in overweight and obese women.

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