Obesity and Hernias: What You Need to Know

When it comes to obesity and hernias, it's time to listen to your gut. Studies show there is a very close relationship between obesity and hernias. Both men and women who are either overweight or obese risk suffering from the formation of painful, bulging hernias. See how you can spot the signs, identify the symptoms, and what you can do to prevent hernias from happening or recurring.

Obesity has been shown to increase the risk of developing certain types of hernias due to the constant strain and pressure of fat against the weakened abdominal wall. As time passes, the hernias continue to grow, becoming increasingly more perilous, posing additional health challenges. Because of weakened abdominals, internal organs are likely to protrude or bulge through the weak areas of the compromised abdominal wall. If left untreated, a hernia can lead to strangulation. 

What IS a Hernia? 

Hernias are classified as a condition where internal organs, fat, fluids, tissues, or muscles become displaced due to a weakened abdominal wall, causing a visible, painful protrusion. A noticeable lump or bulge in the affected area becomes apparent and can grow larger over time if left untreated. Laughing, crying, coughing, straining during a bowel movement, engaging in strenuous activity, or lifting heavy weights/objects can further exacerbate symptoms and increase the size of the hernia. 

Most Common Types of Hernias 

There are six types of hernias that can develop in obese or non-obese adults. While obese individuals can develop any of the following types of hernias, the incisional, umbilical, and hiatal hernia types are the most common to develop in overweight or obese adults. 

• Inguinal Hernia - Also known as a "groin" hernia, an inguinal hernia occurs when a tissue or part of the intestine pushes through a weak area or tear in the lower region of the abdominal wall.
• Femoral Hernia - Most commonly found in females, the femoral hernia occurs when tissues bulk up and bulge through a weak area of the upper inner thigh or groin area. 
• Umbilical Hernia - This type of hernia occurs when tissues, intestine, fat, or fluids bulge through a weak area near the naval (belly button) area. 
• Incisional Hernia - This hernia develops at the site of an incision, usually following abdominal surgery, and can take months or years to form. 
• Epigastric Hernia - This type of hernia occurs when fat pushes through a weak spot near the epigastric region, which is directly located between belly button and breastbone. 
• Hiatal Hernia – The most common form of hernia amongst obese people, this type occurs when part of the stomach swells into the chest cavity through a weak spot in the diaphragm. 

Obesity isn't the only cause for hernias to develop. The following are also likely to contribute to the development of hernias: 

• Pregnancy
• History of abdominal surgery 
• Compromised abdominal wall due to accident and/or injury
• Vigorous exercise, such as heavy lifting without wearing protective gear
• Constipation and "pushing" to relieve bowels
• Chronic coughing/COPD

Hernia Symptoms: What to Watch For 

Hernias can happen to anyone. However, they're most linked to obesity and a compromised abdominal wall. Here's what to look for before the bulge begins to take shape: 

• Chronic pain around abdominal region 
• Pain in upper belly and/or belly button area
• Lump/bulge in the groin or lower abdominal area
• Discomfort when lifting heavy weights/objects
• Abdominal pain while coughing or laughing 
• Abdominal pain while trying to move a bowel

In the case of hiatal hernias, which are very common in obese adults, symptoms may include: 

• Heartburn 
• Indigestion/GERD 
• Difficulty swallowing 
• Frequent regurgitation/vomiting
• Unbearable chest pain 

Obesity and Hernias: A Clinically Recognized Connection 

There is a well-documented relationship between obesity and the development of hernias, particularly in the abdominal and groin regions. Individuals who are significantly overweight or obese face an increased risk due to the continuous strain excess body weight places on the abdominal wall. Over time, this pressure can compromise the integrity of the muscle and connective tissue, leading to the formation of hernias especially hiatal hernias, which occur when part of the stomach protrudes through the diaphragm. 

The chronic stress on abdominal structures can make even simple daily activities more difficult and painful. In many cases, reducing body weight can help alleviate these symptoms and significantly lower the risk of hernia recurrence. While lifestyle modifications such as improved nutrition and regular exercise are important, many patients find long-term success through bariatric surgery. 

For patients with larger or more complex hernias, surgical intervention may be necessary to address symptoms and restore normal anatomical function. However, clinical evidence supports the recommendation that weight loss-particularly surgical weight loss in patients with a BMI of 35 or higher-should precede hernia repair whenever possible to ensure better surgical outcomes and reduce the risk of recurrence. 

What Happens if Hernias Are Left Untreated? 

If left untreated, hernias most likely will continue to get bigger and cause excruciating pain, leading to serious health consequences. In some cases, untreated hernias can become strangulated, leading to such undesirable conditions such as sepsis or enterocolitis (severe intestine inflammation). The unbearable bulge won't go away on its own and will require immediate medical treatment. Most hernias are repaired through open hernia surgery, which can take patients on a very, very long road to recovery. Laparoscopic repair, conversely, offers a minimally invasive treatment with way less downtime, decreased risk of infection, minimal blood loss, and virtually imperceptible scarring. Small incisions are made near the affected area where a "mesh" is then inserted and strategically placed to help keep displaced internal organs, tissues, or muscles in their original place, while re-enforcing the weakened abdominal wall. However, it is important to lose the excess weight PRIOR to surgical hernia repair, otherwise the patient risks recurrence of hernia development after surgery. One study found an 11% hernia recurrence rate after surgical repair in obese patients - that's nearly 1 out of 10 patients who experienced a hernia recurrence AFTER it had been surgically repaired. Patients with a BMI of 35 or higher should seek to lose the excess body weight before scheduling hernia repair surgery to reduce risk of recurrence. Patients considering undergoing weight loss surgery to help shed the unwanted pounds should undergo weight loss surgery prior to hernia repair surgery. 

How to Reduce Your Risk of Developing a Hernia: Preventative Tips to Consider 

While hernias are common to both obese and non-obese individuals, there are effective measures and steps one can take to prevent them from forming in the first place. 

• Maintain a healthy, stable weight
• Implement an effective exercise strategy and a healthy eating plan - long term
• Use proper, safe technique/form when lifting heavy weights/objects and ALWAYS wear supportive gear
• Eat a diet rich in high fiber foods to avoid constipation and bowel strain.
• Stop smoking to avoid persistent hacking and coughing that can put unwanted pressure on abdomen
• Wear comfortable, loose-fitting clothing 

If you're currently overweight or clinically obese and have struggled to achieve long-term results through traditional diet and exercise, you may be a candidate for weight loss surgery. Bariatric surgery not only promotes sustainable weight loss but can also play a critical role in reducing the risk of hernia development and recurrence-particularly for patients dealing with hiatal, umbilical, or incisional hernias. 

Dr. Michael Feiz is a board-certified bariatric surgeon with extensive experience managing obesity-related health conditions, including hernias. Headquartered in Beverly Hills and with locations across Southern California, Dr. Feiz has performed over 10,000 successful procedures and is known for his compassionate, patient-centered approach. He specializes in minimally invasive techniques such as the gastric sleeve, which can alleviate pressure on the abdominal wall, improve hernia-related symptoms, and reduce the risk of recurrence. 

He works closely with each patient to develop comprehensive treatment plans that support both surgical success and long-term health outcomes. If you've been diagnosed with a hernia or are experiencing symptoms and meet the criteria for bariatric surgery, we invite you to schedule a consultation by filling out the form on our Contact Page or calling our office to speak with one of our experienced weight loss surgery specialists.