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Obesity significantly disrupts digestive health by increasing abdominal pressure, altering hormone production, and promoting systemic inflammation. The most common obesity-related digestive disorder is gastroesophageal reflux disease (GERD), where excess midsection weight pushes stomach acid into the esophagus, causing heartburn, chest pain, and regurgitation. Untreated GERD can lead to Barrett's esophagus and esophageal cancer.

Non-alcoholic fatty liver disease (NAFLD), now called metabolic dysfunction-associated steatotic liver disease (MASLD), is the most prevalent chronic liver condition globally and is directly linked to obesity. Excess fat accumulates in the liver, potentially progressing to inflammation (NASH), fibrosis, cirrhosis, and liver failure.

Obesity also increases gallstone risk due to cholesterol imbalances in bile, often causing pain after fatty meals and requiring gallbladder removal. Colon polyps and colorectal cancer are more common in obese individuals, while obesity elevates risks for pancreatic cancer, cholangiocarcinoma, and hepatocellular carcinoma.

Additional digestive issues include constipation, bloating, chronic diarrhea, diverticulosis, and gut microbiome imbalance (dysbiosis), which impair nutrient absorption and increase inflammation. Functional dyspepsia and inflammatory bowel disease severity also worsen with obesity. Weight reduction through diet, exercise, or surgery significantly improves most obesity-related digestive conditions by reducing abdominal pressure and inflammation.