**3.1 Weight reduction**

Lifestyle modification is the recommended first step in the treatment of GERD. However, the only measures that have been shown to be beneficial on the part of obese patient is weight loss [37]. Weight loss is strongly recommended in overweight or obese GERD patients to improve the reflux symptoms [6, 36]. A prospective cohort study has found that in GERD subjects with overweight and obesity, weight reduction was significantly decreased the overall prevalence of GERD with significant improvement in overall symptoms scoring, compared to baseline [38]. The result of this study also showed a substantial reduction in overall GERD scores only observed among subjects who loss body weight ≥5% from baseline. Study conducted by de Bortoli *et al*. found that group of GERD patients who had weight reduction was showing not only a higher rate of symptoms improvement, but also managed to reduce the dosage of proton pump inhibitor (PPI), compared to group without weight reduction [39].

*Gastroesophageal Reflux Disease and Obesity DOI: http://dx.doi.org/10.5772/intechopen.106528*

This study also recommend all patients with GERD to achieve a minimum 10% weight loss from baseline in order to hasten the efficacy of PPI to relieve GERD symptom [39]. The result of the above studies is supported by the finding of dose-dependent relationship between reduction in body weight and improvement of GERD symptoms [40]. Study conducted by Park *et al* found weight reduction was significantly associated with improvement of GERD symptom, but showed no association with improvement in erosive esophagitis [41].
