Overweight, Obesity, and Stomach Ulcers: Indirect Links and Risk Reduction

Excess weight does not directly cause peptic ulcers (H. pylori and NSAIDs are the primary etiologies), but obesity promotes several ulcer‑risk pathways:

• Increased Intra‑abdominal Pressure → promotes hiatal hernia → GERD → esophageal/gastric mucosal injury.
• Hyperacidity – Mechanical pressure and hormonal changes (leptin, ghrelin) may augment acid output.
• NSAID Use – Obesity correlates with osteoarthritis/chronic pain → more NSAID consumption.
• Pro‑inflammatory State – Adipose cytokines (TNF‑α, IL‑6) impair mucosal defense.
• Dietary Patterns – High‑fat, low‑fiber diets delay gastric emptying, increase acid exposure.

Risk‑Reduction Strategies

• Weight loss (even 5–10% reduces GERD/ulcer risk).
• H. pylori testing/eradication if indicated.
• NSAID minimization; use PPI/COX‑2 selective if NSAIDs essential.
• Mediterranean‑style diet, smaller frequent meals, avoid late‑night eating.