• Gastrointestinal symptoms;
  • meta-analysis;
  • obesity;
  • population-based


Weight loss is a recognized alarm symptom for organic gastrointestinal (GI) disease, yet the association between obesity and specific GI symptoms remains poorly described. A meta-analysis was conducted to determine which GI symptoms predominate among obese individuals.

A search of the literature using the databases MEDLINE, EMBASE PubMed and Current Contents (1950 – November 2011) was conducted. All studies assessing GI symptoms and increasing body mass index (BMI)/obesity were included. English and non-English articles were searched. A random effect model of the studies was undertaken.

Overall, significant associations between GI symptoms and increasing BMI were found for upper abdominal pain (odds ratio [OR] = 2.65, 95% confidence interval [CI]: 1.23–5.72), gastroesophageal reflux (OR = 1.89, 95% CI: 1.70–2.09), diarrhoea (OR = 1.45, 95% CI: 1.26–1.64), chest pain/heartburn (OR = 1.74, 95% CI: 1.49–2.04), vomiting (OR = 1.76, 95% CI: 1.28–2.41), retching (OR = 1.33, 95% CI: 1.01–1.74) and incomplete evacuation (OR = 1.32, 95% CI: 1.03–1.71). However, no significant associations were found for all abdominal pain, lower abdominal pain, bloating, constipation/hard stools, fecal incontinence, nausea and anal blockage.

Several key GI symptoms are associated with increasing BMI and obesity. In addition, there were a number of other GI symptoms that had no relationship with obesity. A greater knowledge of the GI symptoms associated with obesity along with the physiology will be important in the clinical management of these patients.