Effects of obesity on abdominal wall morphology and diastasis recti abdominis in women

Objectives: Obesity can lead to structural alterations in the abdominal wall, which are important to assess for effective obesity management. This study aimed to investigate the impact of obesity on abdominal wall morphology and the presence of diastasis recti abdominis (DRA) in women, as well as the correlation between body mass index (BMI) and abdominal wall parameters. Methods: Women were divided into two groups based on BMI: non-obese (BMI<30 kg/m², n=37) and obese (BMI≥30 kg/m², n=36). Using ultrasound, measurements were taken for umbilical subcutaneous adipose tissue (SCAT) thickness, abdominal muscle thickness, linea alba (LA) distortion (using a distortion index formula) and width (using inter-rectus distance, IRD), and presence of DRA. Results: The obese group showed significantly greater umbilical SCAT thickness, distortion index scores, and IRD measured 2 cm above the umbilicus compared to the non-obese group (p<0.05). No significant differences were observed in abdominal muscle thickness between the groups (p>0.05). The prevalence of DRA was higher in the obese group (33.3%) than in the non-obese group (10.8%) (p<0.05). Significant positive correlations were found between BMI and umbilical SCAT thickness (p=0.610), distortion index scores (p=0.489), and IRD measured 2 cm above (p=0.359) and below the umbilicus (p=0.304) (p<0.05). Conclusion: Women with obesity exhibited increased umbilical SCAT thickness, greater linea alba distortion and width, and a higher prevalence of DRA compared to non-obese women. These findings suggest that elevated BMI may negatively influence abdominal wall morphology. Considering these morphological changes may be important in the clinical evaluation and management of obesity.