Having a hysterectomy can increase your odds of weight gain. But there are steps you can take to prevent this from happening or lose weight after your operation.
Having a hysterectomy can increase your odds of weight gain. But there are steps you can take to prevent this from happening or lose weight after your operation.
Losing weight can be tricky at the best of times. But if you’ve had a hysterectomy, weight loss may be even harder due to changes in your hormones, metabolism, muscle mass, and fat storage.
Don’t let that discourage you, though. It’s still possible to lose weight and improve your overall health — uterus or not.
Below, we’ll dive into how to lose weight after a hysterectomy and the factors that can cause post-op weight gain in the first place.
Before we get to the tips for how to lose weight after a hysterectomy, it’s good to understand what you’re up against.
Having a hysterectomy doesn’t guarantee you’ll gain weight, but post-op weight gain is a pretty common side effect. Older research shows that 12 percent of women report weight gain after hysterectomy.
Other research shows weight gain is more likely in those who’ve had a hysterectomy.
A 2009 study looked at 236 women who had a hysterectomy and 392 control women (those who hadn’t). Women with hysterectomies had a higher weight and body mass index (BMI) than the control group at baseline. One year later, the average weight gain after hysterectomy was about three pounds compared to roughly 1.3 pounds for the control group.
Weight gain of more than 10 pounds happened in 23 percent of women with hysterectomies compared to 15 percent of the control group.
What’s more, women with a higher weight before surgery and those who had weight fluctuations throughout their lives were at the most risk of weight gain.
Though weight gain is common after this medical procedure, it doesn’t happen to everyone. You might even find it’s easier to lose weight if a hysterectomy improves symptoms that were impacting your ability to eat well and exercise before.
The same 2009 study found that the type of hysterectomy can affect weight gain.
Women who had abdominal hysterectomies (removal by opening the abdomen) gained more weight than those who had vaginal hysterectomies (removal through the vagina) or laparoscopic hysterectomies (removal through small incisions and/or the vagina).
Why? It’s unclear, but it could be because it takes longer to recover from an abdominal hysterectomy.
Another study found that those who got a bilateral oophorectomy (when both ovaries are removed) had greater BMI increases compared to those who got a hysterectomy without ovary removal or those who went through menopause naturally (which can also cause weight gain). This could be due to the larger drop in estrogen that happens when ovaries are removed.
It’s also important to note that women who get hysterectomies tend to have a higher weight pre-surgery than those who don’t, making studies on post-op weight gain tricky. This may be because obesity can lead to conditions that require a hysterectomy, like fibroids.
Before getting into how to lose weight after a hysterectomy, let’s discuss why weight gain can happen after the surgical procedure.
It’s not entirely clear what causes post-hysterectomy weight gain. But these factors can play a role:
Reduced estrogen. If your ovaries are removed as part of your hysterectomy (called an oophorectomy), you’ll experience a drop in estrogen and may enter menopause, regardless of your age. Even if your ovaries are left intact, a hysterectomy could still reduce estrogen production. Lower estrogen can lead to low energy levels, increased hunger, a decrease in total and resting energy expenditure (how many calories your body burns overall and at rest), and a redistribution of fat from the thighs and butt toward the belly.
Less exercise. You’ve just gone through major surgery, so you’re probably not hitting the gym (nor should you!). Exercising less while recovering and beyond can lead to weight gain.
Loss of muscle. You may also lose muscle mass during hysterectomy recovery. This can slow your metabolism, as muscle burns more calories than fat. Women also naturally lose muscle with age, and many hysterectomies are done later in life, adding to muscle loss problems.
Increased insulin resistance. Estrogen is thought to regulate insulin sensitivity, and a hysterectomy may worsen insulin resistance. This could lead to increased blood sugar (glucose) levels, weight gain, or type 2 diabetes. In fact, some research shows there’s a 40 percent higher risk of diabetes in women who’ve had hysterectomies.
Sleep loss. You might struggle to sleep as you’re recovering from surgery and experiencing menopause symptoms like night sweats. Sleep loss can increase hunger and food cravings and tank your motivation to work out.
Can you lose weight after a hysterectomy? You sure can! Keep reading for guidance.
Here are the steps you can take for weight loss and weight management.
You probably knew this one, but let’s break it down. Eating a balanced diet can help you stay in a calorie deficit — when you eat fewer calories than your body needs each day. This promotes weight loss.
Make sure you’re noshing on a variety of fresh fruits, vegetables, whole grains, lean protein, and healthy fats.
In particular, focus on eating enough protein. Protein can help you feel fuller, reduce cravings, and maintain and build muscle. Win-win-win.
Go for lean protein sources like:
Chicken
Turkey
Fish
Tofu
Tempeh
Besides eating a healthy diet, be sure you’re staying hydrated. Water is not only good for overall wellness, but it’s good for weight loss, as it can help you feel fuller.
Once you get the go-ahead from your surgeon to exercise post-surgery, try incorporating regular exercise into your schedule. You can start with low-impact exercises (like walking or water aerobics) and build up to more vigorous workouts, following any advice from your healthcare provider.
Aim for 150 to 300 minutes of moderate cardio a week. Start slow and build your way up to these numbers — and go beyond them, when you’re ready — to promote weight loss.
As well as cardio, prioritize strength training in your exercise routine.
Strength training can include:
Bodyweight exercises
Resistance machines in the gym
Using dumbbells or resistance bands
This can help you build and maintain muscle mass to increase your metabolism. Aim for two or more sessions a week.
As much as you can, aim to get seven to nine hours of sleep a night. This can help with the healing process and keep your hunger hormones in check long-term.
To get enough sleep, try to:
Reserve your bedroom for sleep and sex only
Limit caffeine to the morning and early afternoon
Wind down before bed with relaxing activities
Make sure you’re bedroom is cool, especially if you’re experiencing hot flashes from early menopause
You can also aim to go to bed and wake up at the same time every day, even on weekends.
Hormonal imbalances could also be at play.
Hormone-replacement therapy — or menopause hormone therapy (MRT) — can help replace hormones that are reduced after a hysterectomy surgery. This can help improve some symptoms that may be contributing to weight gain, like hot flashes and sleep disturbances.
One small study found that HRT could reduce how much body fat is gained during early menopause and prevent the redistribution toward belly fat.
BTW, if a hysterectomy has triggered early menopause, you can learn more about how to lose weight during menopause in our guide.
Weight loss medication can help some people with excess weight and obesity lose weight. Different medications work in different ways, but many can:
Reduce your appetite
Help you feel fuller
Curb cravings
Control blood sugar
This can help you stick to nutritious food choices and healthy portion sizes that promote weight loss.
Your options include injections and tablets, such as:
Semaglutide (Ozempic®, Wegovy®, Rybelsus®, and compounded semaglutide)
Tirzepatide (Mounjaro®, Zepbound®, and compounded tirzepatide)
Topiramate (Topamax®)
Naltrexone-bupropion (Contrave®)
A healthcare provider can let you know whether you’re a good candidate for medication and, if so, which ones.
In general, moving toward a healthy weight is a great thing for your health and well-being. But, with a hysterectomy, you’ve just had major surgery (although you probably don’t need us to tell you that).
The point is, there are some safety considerations to think about.
You don’t want to rush into working out when your body’s not ready — or before your medical provider says it’s OK. This could slow your recovery and increase your risk of injury.
Reach out to your healthcare provider to get advice on when to start adding more physical activity to your routine. In the meantime, focus on nutritious foods, water, and getting enough sleep.
If you’ve had a hysterectomy (or you’re booked for one), you’re more likely to gain weight post-op. But it’s not inevitable, and it’s not irreversible.
Here are the key things to keep in mind:
Hysterectomy weight gain can be caused by several factors. Hormonal changes, loss of muscle, reduced physical activity, disrupted sleep, and increased insulin resistance can all contribute to weight gain.
It’s possible to lose weight after a hysterectomy. Focus on eating whole foods (especially protein), doing more movement (including strength training), and improving your sleep to promote weight loss. Make sure you don’t rush into exercise, though.
Consider medication to help. Sometimes, lifestyle changes don’t cut it. Consider hormone-replacement therapy or weight loss medication to kickstart your weight loss.
If weight loss medications are something you’re considering, you can take our free online weight loss assessment. A licensed healthcare provider will go over your answers and let you know if weight loss drugs are suitable for you and what a treatment plan could look like.
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