Background: Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms. Aims/Objectives: To investigate whether BMI has significance on IQoro (R) neuromuscular training (IQNT) effectiveness in treating HH-related symptoms. Material and Methods: Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite proton pump inhibitor medication, were consecutively referred for 6 months IQNT comprising 11/2 minutes daily. They were grouped by BMI which was recorded before and after IQNT, as were their symptoms of IED, reflux, heartburn, chest pain, globus sensation, non-productive cough, hoarseness, and misdirected swallowing. They were also assessed on food swallowing ability, water swallowing capacity and lip force both before and after treatment. Results: After IQNT, all BMI groups showed significant improvement (p amp;lt; .001) of all assessments and symptoms; and heartburn, cough and misdirected swallowing were significantly more reduced in the severely obese. Conclusions and significance: IQNT can treat HH-related IED and GERD symptoms as successfully in moderately or severely obese patients as in those with normal bodyweight.