The research had shown that patients with isolated GERD and patients with GERD and concomitant obesity had different mechanisms that lead to the disruption of the lower esophageal sphincter. GERD patients with concomitant obesity had chronic inflammatory process in adipose tissue, which leads to reduction of protective adipokine (adiponectin) level and increase of inflammatory adipokine (visfatin) level. The patients with isolated GERD had prevalence of the parasympathetic nervous system and increased aggression of gastric juice.