Is Obesity a Risk Factor for Barrett’s Esophagus?

While the role of obesity in gastroesophageal reflux disease (GERD) and the role of GERD in Barrett’s esophagus (BE) are independently well established, there is an implied assumption that obesity plays a role in BE. The authors of this large systematic review and meta-analysis explored the association of body mass index (BMI) and risk of BE in patients who were undergoing evaluation for bariatric surgery. 

A total of 13,434 patients (ages, 36.7-46.3 years; BMI, 39-51.2 kg/m2; female, 54%-91% of participants) from 29 studies were included in the final analysis. The researchers reported there were only 114 cases of BE, with a pooled prevalence of only 0.9% (95% CI, 0.7%-1.3%). On meta-regression (n=10 studies), a weakly positive association between BMI and the prevalence of BE (β=0.15 [95% CI, 0.02-0.28]; P=.03) and a stronger association with BMI and GERD were noted (β=3.9 [95% CI, 0.4-7.5]; P=.03). The authors reported that study limitations included a lack of histopathological confirmation of BE in all studies, a patient population of mostly women, and an absence of information about endoscopist experience.