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Dietary and lifestyle modifications are typically the first-line approach: Eat smaller, more frequent meals rather than large portions Avoid lying down for at least two to three hours after eating Elevate the head of the bed by 1520 cm if nocturnal symptoms are present Reduce or avoid known reflux triggers such as fatty or spicy foods, caffeine, alcohol, and carbonated drinks Maintain a healthy weight, as excess abdominal weight increases intra-abdominal pressure Pharmacological management may also be appropriate in some cases

Additionally, the peripheral administration of exendin-4 and liraglutide regulates food intake by activating the GLP-1 receptors expressed on both vagal afferents and CNS [139]

Ethics declarations Competing interests MV has within the last three years, served as consultant for Lundbeck, Eli Lilly and Johnson & Johnson