Why do women gain weight after a hysterectomy?

Women commonly gain weight after hysterectomies because of lifestyle changes due to menopause, according to Dr. Wulf Utian of The Cleveland Clinic. This change in weight is most likely caused by a reduction of physical activity and muscle mass rather than differences in estrogen or progesterone levels.

While Dr. Wulf Utian does admit there is some evidence that hysterectomies cause larger weight gains than natural menopause in women, he concludes that nearly all women gain weight after menopause. Thus, he attributes most weight gain associated with hysterectomies to the patients reaching menopause. Activity levels drop off as women reach menopause, resulting in fat gain and muscle loss. This process can be reversed with appropriate weight training and dietary changes.

However, after a full hysterectomy, hormone changes occur that can cause shifts in fat distribution, according to Dr. Fredrick Jelovsek. As estrogen and progesterone levels drop due to removal of the ovaries, androgen levels in the body encourage storage of fat in the stomach area. While these changes are identical to the processes that occur when a woman reaches menopause, a full hysterectomy prematurely initiates these changes. Another factor that Dr. Jelovsek highlights is the weight gain associated with an invasive surgery. Activity levels postsurgery are greatly reduced for up to two months, causing significant changes in metabolism.