Acid reflux, also known as gastroesophageal reflux disease (GERD), is a common digestive condition that occurs when stomach acid flows back into the esophagus (the tube connecting your mouth and stomach). GERD causes symptoms like heartburn, regurgitation, and chest pain— imposing a major discomfort and challenge to your ability to eat.
Body weight, specifically when one is deemed “over”-weight or ob*se, is often presumed to be a leading contributor of reflux. Consequently, suggestions to lose weight are a first-line defense prescribed by most medical professionals.
But it’s largely oversimplified to assume that weight is a primary and/or sole factor in the development of reflux. To make matters worse, efforts to diet for weight loss are not only ineffective but also, lead to a spectrum of behaviors from binge eating to restrictive eating— both known to trigger digestive issues like reflux. In this blog post, we’ll discuss important considerations to sustainably alleviate reflux and heartburn.
Is reflux even related to weight?
As mentioned above, dieting (even “clean” eating) closely resembles disordered/restrictive eating— so, it’s plausible to wonder if symptoms like reflux are less related to weight and more related to the interventions prescribed to lose weight.
While some associations might exist between weight and reflux, more notable are the studies that support a handful of modifiable lifestyle behaviors known to trigger or worsen reflux, including:
- Eating past fullness
- Skipping breakfast
- Eating quickly
- Eating very hot foods
- Strenuous exercise
Arguably, 80% of these behaviors spike from patterns of disordered eating. In fact, eating quickly and eating past fullness are two behaviors often experienced in response to restrictive eating. Both result from the biological need to satisfy rebound hunger— the extreme hunger you feel after not eating sufficiently for extended periods. Also, skipping meals like breakfast or dinner can extend the time between eating opportunities— the result is a buildup of stomach acid that triggers discomfort.
Managing reflux: the role of diet and lifestyle
Regardless of etiology, it’s crucial to address reflux since chronic regurgitation can lead to more severe health issues, including esophageal damage. However, traditional approaches often involve the avoidance of entire foods or food groups. In addition to this is the suggestion to skip nighttime eating in an effort to avoid sleeping on a full stomach. For populations (like dancers) who are both prone to disordered eating and reliant on nighttime eating for performance recovery, these traditional approaches can do more harm than good.
Logistical tweaks to alleviate reflux
Before we unravel diet and exercise considerations, start with these easy modifications. First, using a wedge pillow to elevate the head of your bed during sleep can reduce nighttime symptoms by preventing stomach acid from flowing back into the esophagus. If accessible, take a leisurely walk or participate in cool-down movement patterns (gentle yoga and meditation) after eating to aid with digestion. Last, choose loose-fitting clothing to avoid compressing your stomach. This might be extra challenging for dancers who struggle with body image— the thought of going up a size in clothing can ignite worries and self-doubt. Building a more supportive body image will be incredibly helpful.
Consider your approach to stress
Stress worsens symptoms of reflux. Start to notice if your reflux ignites when you’re stressed, nervous, or anxious. If so, lean into support— a licensed mental health provider can assist with building a toolbox of coping behaviors to navigate through periods of emotional distress. Activities like meditation, yoga, light pilates, and foam rolling are especially supportive for easing digestion. Here’s an article that discusses more ways in which dancers can work to manage stress and overwhelm.
Evaluate your relationship with food
Elimination diets are, unfortunately, a common intervention used in hopes of removing the source of discomfort. However, elimination diets can quickly spiral into disordered eating and exacerbate mealtime stress. Working on your relationship with food often means dismantling food rules and challenging rigid eating patterns. Rather than omitting specific foods, utilize gentler nutrition modifications to alleviate discomfort (more on this below).
Lean into gentle nutrition
Smaller, more frequent meals can be beneficial for those with acid reflux— this means planning meals and snacks about 2-3 hours apart. In attempts to promote a comfortable degree of fullness, consider the staying power of your choices. Ensure your plate contains a variety of foods, including those rich in protein, fibrous grains, veggies, and fruit. Slowing down at meals is another helpful tool, along with mindful eating (though, less practical for those who navigate busy schedules). When accessible, pay close attention to your body’s signals and responses to different foods. When you eat, focus on your meal and chew thoroughly.
You might notice that when compared to other foods, some foods can trigger symptoms. And for some, the opposite might hold true. A recent study examined the use of Manuka honey as a possible addition in the management of reflux (though results are mixed). Working alongside a registered dietitian is encouraged to navigate specific food triggers. Though common culprits include spicy and acidic foods, along with caffeine and alcohol, reflux triggers can vary from person to person. A temporary food journal can help in the identification process, but this work is only encouraged for dancers who are working alongside a licensed dietitian.
Evaluate your relationship with movement
Overexercise is a common struggle for dancers— active schedules are often compounded with extra conditioning and cross-training. As mentioned earlier, strenuous activity is known to worsen symptoms of reflux and should be considered for those who are struggling. For dancers, time away from the studio— even if it’s just for a lunch break might help. Identifying options for joyful movement means stepping away from prescriptive routines (this can be extra challenging for dancers) and rather, relying on more supportive conditioning efforts.
If symptoms persist
Once you’ve attempted these modifications, and if symptoms persist, consult with a licensed medical doctor about medical management to alleviate the discomfort from reflux/GERD. Digestive aids and antacids like Tums and GasX are generally easily accessible while H2 blockers and PPIs can be prescribed by a medical doctor. Most importantly, consult with a licensed medical doctor to ensure these medications do not interact with others.