Can a Hernia Cause Weight Gain? The Relationship Explained

Do hernias lead to weight gain, or does being overweight cause hernias? This seemingly simple question reveals a complex relationship between hernias and obesity. While a hernia alone does not directly cause weight gain, the two conditions often go hand-in-hand.

What is a Hernia?

First, let's start with a quick hernia overview. A hernia occurs when an opening in the muscle wall allows internal organs or fat to push through. This creates a visible bulge under the skin.

Hernias most commonly form in the abdomen, between the chest and hips. Some specific types include:

• Inguinal hernia: Occurs in the groin area, when intestine pushes through a weak spot in the lower abdominal wall. Most common overall.
• Hiatal hernia: Part of the stomach squeezes through the diaphragm muscle into the chest cavity. Often caused by intense coughing.
• Umbilical hernia: Intestine protrudes through abdominal wall near the belly button. More common in infants but can affect adults.
• Incisional hernia: Develops through a scar in the abdominal wall, after surgery or injury.

Hernias themselves are usually not dangerous. However, they can lead to pain, constipation, difficulty eating, and potentially serious complications if the trapped intestine becomes strangulated.

Why Obesity Raises Hernia Risk

So where does weight factor in? Simply put, carrying excess weight increases strain and pressure on the abdominal muscles. This can weaken the muscles over time, causing openings for hernias to form.

Multiple large studies have found that obesity is a significant risk factor for developing a hernia. For example, a 2015 report in JAMA Surgery looked at over 100,000 adults undergoing bariatric surgery. Obese patients were found to have 2 to 4 times higher odds of having a hernia, compared to non-obese patients.

Likewise, a 2021 study in Surgical Endoscopy followed patients after gastric bypass surgery. During the 3-year follow-up period, obese patients had a hernia recurrence rate of 11.6%, compared to just 3.4% for non-obese patients.

The more overweight someone is, the higher their hernia risk becomes. People with severe or "morbid" obesity are especially prone to developing multiple hernias along the abdominal wall.

This sheds light on the first direction of the relationship between hernias and weight gain. Carrying excessive body fat strains the abdominal muscles, leading to hernias. But what about the reverse - can a hernia itself cause obesity?

Do Hernias Themselves Lead to Weight Gain?

A hernia forms when the muscle wall weakens, allowing internal contents to push through. But the hernia itself does not directly cause fat cells to accumulate. Simply having a hernia does not make someone gain a significant amount of weight.

That said, there are some indirect ways a hernia could contribute to weight gain:

• Inactivity due to pain/discomfort - Large hernias can cause pain and make exercise difficult. Being less active burns fewer calories.
• Change in eating habits - Some hernias may cause difficulty swallowing or nausea, potentially decreasing appetite. Others result in constipation, which can increase appetite.
• Slowed metabolism - Very large hernias that restrict organ function could potentially cause metabolic changes. But evidence for this is limited.

While these factors could lead to modest weight gain in some cases, a hernia's direct contribution is small. Obesity itself is the prime reason hernias develop and expand in the first place.

The Vicious Cycle of Hernias and Obesity

When looking at the relationship between hernias and weight gain, we see something of a vicious cycle.

Obesity puts strain on the abdominal muscles, leading to hernias. But once a hernia forms, being overweight can then make it progressively worse over time.

Excess body fat increases pressure on the hernia. Repeated stress on the abdominal wall from coughing, bending, heavy lifting, and other activities causes the opening to expand. Obese patients tend to develop larger hernias that are more difficult to treat.

In rare cases, a loop of intestine can become trapped within the hernia, causing intense pain. This strangulated hernia requires prompt medical attention. Obese patients are at higher risk for this complication.

Finally, obese patients are more likely to develop multiple hernias along the abdominal wall. Their excessive weight and weakened muscles create an environment prone to repeated hernia formation.

In essence, while hernias do not directly cause weight gain, obesity significantly contributes to their development and progression. Shedding pounds can help halt this vicious cycle.

Benefits of Weight Loss Before Hernia Repair

When a hernia causes discomfort or complications, surgery is often required to repair the weakness in the muscle wall. Obese patients face increased risks during this hernia surgery.

Losing weight prior to the procedure can greatly improve outcomes. According to a 2020 research review in JAMA Surgery, even a 5-10% reduction in body weight can lower risks.

Benefits of weight loss before hernia repair include:

• Better surgical access - Less abdominal fat allows the surgeon better visibility and access to the hernia site. Obese patients are prone to surgical site infections, which are reduced with weight loss.

• Decreased complications - Obesity increases risks for wound infections, blood clots, respiratory issues, and other problems after surgery. Shedding excess pounds lowers these risks.

• Improved recovery - Being overweight slows healing and often lengthens hospital stays. Losing weight helps patients bounce back faster after the operation.

• Reduced hernia recurrence - Hernias redevelop in up to 10% of obese patients after surgery. Weight loss prior to repair may make long-term results more durable.

For these reasons, bariatric surgeons often encourage obese patients to lose weight before undergoing hernia repair procedures. Even modest weight reduction creates a better trajectory for successful treatment.

The Bottom Line: Lose Weight to Prevent and Manage Hernias

Hernias and obesity clearly go hand-in-hand. While hernias themselves do not cause weight gain, excess weight is a driving force behind their development.

The abdominal strain from obesity leads to hernias. In turn, hernias often expand and cause escalating problems when combined with obesity.

Losing weight eases the pressure on abdominal muscles, lowering future hernia risk. For those with existing hernias, shedding pounds can minimize complications and improve surgical outcomes.

In short, maintaining a healthy weight should be part of both hernia prevention and management. Controlling obesity stops the vicious cycle between the two conditions.

While hernias may not directly cause weight gain, the link between the two highlights the importance of overall health and fitness. Keeping the body trim and muscles strong offers lifelong benefits, including reducing hernia risk.