A hernia happens when an internal organ or tissue pushes through a weak spot in the surrounding muscle or tissue. While various factors can contribute to hernia development, obesity is one of the significant risk factors.¹ Here's why:  

• Increased Intra-abdominal Pressure: Excess weight puts extra pressure on the abdominal wall. This constant strain can weaken the muscles over time, making them more susceptible to tearing or developing openings through which a hernia can protrude.²
• Weakened Connective Tissue: Obesity can affect the strength of connective tissue and create changes in collagen, a key component of connective tissue. This can weaken the strong sheets of tissue that normally hold organs in place.³
• Technical Challenges in Diagnosis: In individuals with significant abdominal fat, it can be more challenging for patients and doctors to detect a hernia during a physical examination. The extra tissue can hide the bulge which could delay diagnosis and treatment.²
   

When a hernia requires surgical repair, extra weight can make things more complicated. There are several factors your doctor may consider in deciding whether to recommend weight loss before hernia surgery. We have included some of them below to help you prepare for a discussion with your doctor.

• Increased Surgical Risks: Obese patients may have a higher risk of certain surgical complications, including:
  • Wound Infections: Excess body fat (adipose tissue) has a less robust blood supply, potentially increasing the risk of infection at the surgical site.⁴
  • Blood Clots: Obesity is a known risk factor for blood-clot-related complications like deep vein thrombosis (DVT) and pulmonary embolism (PE).⁵
  • Cardiovascular Issues: Obese individuals are more likely to have underlying heart conditions such as (but not limited to) heart failure, high blood pressure, heart rhythm disorders, and a history of blood clots that can increase surgical risks.⁶
  • Breathing Problems: Anesthesia and the surgical position can sometimes pose challenges for obese patients with pre-existing breathing issues.⁷
• Potentially More Complex Surgery: Operating on someone with significant abdominal fat can be technically challenging for surgeons as the extra tissue may make it harder to see and work in the area.⁸
• Higher Recurrence Rates: Research shows those with obesity may have a slightly higher risk of hernia recurrence after surgical repair, compared to individuals with a healthy weight. This could be due to increased intra-abdominal pressure and potentially weaker tissue.⁸
   

A collaborative and shared care approach with your doctor is key to understanding your hernia repair and the post-operative recovery process. Below are some topics that you may want to discuss with your doctor.

• Weight Management: Losing even some weight before surgery can help to reduce the risk of certain complications. Your surgeon may recommend delaying elective hernia repair until some weight loss is achieved.⁹
• Preparing for Surgery: Your medical team will want to make sure any other health conditions, including diabetes or heart problems, are well-managed before surgery. Lifestyle modifications (such as quitting smoking) are also typically encouraged.⁹
• Surgical Technique: You and your surgeon should decide the best technique and treatment for your specific situation.
• Post-operative Care: Your care team will likely provide you with post-operative instructions, including for wound care and returning to everyday activities. Ask your doctor any questions you have about them. You can also check out our post-op guidelines for additional general information.⁹
• Long-term Lifestyle Changes: Maintaining a healthy weight through diet and exercise after surgery are key to helping to reduce the risk of a hernia coming back and to overall health.⁹
   

If you are an obese individual with a hernia, it's important to have an open and honest conversation with your doctor. Understanding the risks and benefits of having surgery, exploring weight management strategies, and working together to develop a personalized treatment plan can help you and your doctor effectively manage your care and recovery. Find a hernia repair surgeon now so you can get started.

The guidance provided in this article follows general rules that should be discussed with your doctor. This article is for informational and educational purposes only. It does not substitute for medical advice. If in doubt, always consult your doctor.