Gastroesophageal reflux disease (GERD) has a high prevalence in the obese population with a direct correlation between increased BMI and GERD. This correlation is multifactorial, with also more complicated forms (esophagitis and metaplasia) present in obese patients, even in the absence of frank reflux symptoms. Therapeutic success largely depends on weight loss, and bariatric surgery is the cornerstone of treatment for both diseases. Roux-en-Y gastric bypass is the intervention of choice for obese patients suffering from GERD, while sleeve gastrectomy can on the contrary induce increased reflux in the long term. Classic anti-reflux surgery (fundoplication) can also be offered to these patients, while being aware of the high risk of recurrent symptoms for BMI > 30-35 kg/m2.