Apart from the metabolic complications associated with obesity, a paradigm of increased intra-abdominal pressure has been recognized. This pressure effect is most apparent in the setting of marked obesity (BMI ≥ 50 kg/m2) and is espoused by bariatric surgeons.

Findings from bariatric surgery and animal models suggest that this pressure elevation may play a role (potentially a major one) in the pathogenesis of comorbidities of obesity, such as the following :

• Pseudotumor cerebri;
• Lower-limb circulatory stasis;
• Ulcers;
• Dermatitis;
• Thrombophlebitis;
• Reflux esophagitis;
• Abdominal hernias;
• Possibly, hypertension and nephrotic syndrome.