How to lose weight after hysterectomy

If you’ve had a hysterectomy, you may have noticed some changes, including in your body weight. Research suggests that weight gain after hysterectomy is common. 

But here’s the good news: While weight gain is a risk, it’s not a guarantee. And even if you’ve gained a few pounds, weight loss after hysterectomy is absolutely possible. 

Below, we explore how to lose weight after hysterectomy, why weight gain happens in the first place, and what makes some women more at risk than others.

Yes, hysterectomies can cause weight gain. In one study, premenopausal women gained an average of 3 pounds in the year after surgery. Nearly one in four women gained more than 10 pounds. On the other hand, women who didn’t have the procedure gained just over 1 pound on average. 

Additional research found a similar pattern: Women who undergo a hysterectomy in midlife are also more likely to gain weight in the years that follow. They also tend to see shifts in their body composition, specifically gaining fat while losing muscle.

That said, weight gain isn’t inevitable with a hysterectomy. Some women maintain or even lose weight if their procedure relieves symptoms that previously limited their ability to exercise or eat well.

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Hysterectomy types and weight gain 

Research also shows that the type of hysterectomy you have can influence your likelihood of gaining weight:

• Total hysterectomy with oophorectomy (removal of the uterus and ovaries) can trigger menopause and a drop in estrogen. This, in turn, may cause other changes like a lower metabolism, increased belly fat, and insulin resistance. (For what it’s worth, natural menopause in those who don’t undergo hysterectomies is also associated with weight gain due to the loss of estrogen.)

• Partial hysterectomy (removal of the uterus but not the ovaries) can sometimes result in earlier menopause. But weight changes may be less dramatic than with a full hysterectomy because the ovaries are still intact.

• Abdominal hysterectomy (which is performed through an incision in the abdomen) typically requires longer recovery times than vaginal or laparoscopic hysterectomies. Your healthcare provider may recommend avoiding physical activity for an additional 2–3 weeks, though instructions are individualized and may vary.

In general, being sedentary for a few more weeks — and out of the gym — may lead to additional weight gain. If you’re pretty physically active, one way to counteract this would be to eat fewer calories than you typically did pre-op. Just make sure you’re still getting the nutrition you need! (More on this and other post-hysterectomy weight-related tips later.)

There isn’t just one reason hysterectomies can cause weight gain. Rather, multiple physical, hormonal, and lifestyle factors can contribute to weight gain post-procedure. They range from a lack of physical activity during recovery to changes in estrogen and stress levels.

Here are some of the most common reasons you might gain weight after having a hysterectomy:

• Less exercise. After surgery, your movement may be restricted for 2–8 weeks while your body recovers. Plus, you may be feeling pretty fatigued, which can make it tough to do even gentle exercise or minor physical tasks. Exercise is critically important for weight maintenance. It also helps maintain muscle mass, which_, in turn, supports a healthy metabolism. So, if you’re not working out, you may lose muscle mass, and your metabolism may slow down as well. 

• Age. Women lose muscle and gain fat more easily as they age. Depending on when you have your hysterectomy, your body may be primed to lose more muscle during recovery and gain fat instead.

• Reduced or loss of estrogen. Oophorectomies remove ovaries, which trigger early menopause and cause your estrogen to drop. This results in lower energy levels and a slower metabolism. Some people may also notice appetite or sleep changes during this transition. Even if you had a partial hysterectomy, the surgery can sometimes reduce ovarian function and lead to an earlier drop in estrogen. Lower estrogen is also linked to insulin resistance, which can lead to weight gain.  

• Other health conditions. Obesity can be a risk factor for certain conditions that might require a hysterectomy, such as uterine fibroids. Research shows that women with fibroids or menorrhagia (longer or heavier periods) may be more likely to gain weight after hysterectomy than those without these conditions. 

• Higher stress levels. Surgery can also take a mental and emotional toll on the body. After a hysterectomy, it can be easy to get stressed — you may not be able to do your usual activities, and your to-do list can pile up while you recover. This added stress matters because it’s linked to weight gain. Stress can increase cortisol and sometimes influence appetite-regulating hormones like ghrelin, making calorie-dense comfort foods harder to resist. 

• Poor sleep. The pain and stress from surgery can mess with your sleep. And if you have a total hysterectomy, night sweats from surgical menopause and estrogen loss can worsen your zzz’s. The less sleep you get, the more likely you are to feel grumpier, overwhelmed, and less motivated to work out. You’re left in a state that can feel practically primed for weight gain. 

So, you can gain weight after a hysterectomy. But can you lose it? Fortunately, the answer is yes. You can lose weight after a hysterectomy with a bit of patience and some lifestyle changes.

1. Follow a healthy, balanced diet

Eating a balanced diet can support your post-hysterectomy recovery by giving your body the nutrients it needs to heal and rebuild strength. It can also help you stay in a calorie deficit, aka when you eat fewer calories than you burn — a key component of weight loss. 

While everyone's needs differ, reducing your daily intake by 500-700 calories is usually a good place to start for losing weight. (Just remember to chat with your healthcare provider before cutting back cals and making any other dietary changes, especially post-op.) 

To support weight loss, many experts recommend getting about 20%--25% of your calories from protein, 40%--50% from carbohydrates, and less than 30% from fat (ideally healthy fats). Again, these are general guidelines, and what’s best can vary from person to person. 

Protein is a key ingredient because it helps keep you full, reduces cravings, and preserves muscle mass. All of these are wins if your goal is to lose weight after a hysterectomy. Prioritizing lean protein, in particular, might include adding the following to your diet: 

• Chicken

• Fish

• Turkey

• Tofu

• Beans

• Lentils

• Tempeh

Fiber-rich fruits and vegetables are great options to support digestion and help fill you up without packing on the calories. Plus, they tend to be rich in antioxidants and other recovery-supporting nutrients, including vitamin C. Whole grains like oatmeal, brown rice, and quinoa are also good carbohydrate options. And when it comes to fats, go for healthy sources, such as extra virgin olive oil and fatty fish (e.g. salmon, tuna). 

A healthy, balanced diet is nothing if it doesn’t include drinking about 8–9 cups of water daily. Staying well-hydrated can support weight loss and recovery. 

Also, if you’re experiencing hot flashes, consider avoiding spicy foods, alcohol, and caffeine, and discuss your symptoms with your healthcare provider for personalized guidance.

2. Safely reintroduce exercise 

Follow your healthcare provider’s guidance regarding exercise post-op — no ifs, ands, or buts. 

That said, walking is generally encouraged during the first few days to weeks after surgery. It’s even required before you can leave the hospital. Let’s be very clear: We’re talking about short walks. 

In fact, the American College of Obstetrics and Gynecology recommends spending at least eight hours out of bed and off the couch during recovery. Now, this doesn’t mean you should trade TV time for TRX training at the gym. Instead, you can take short, light walks around the house or the block, gradually increasing the distance with your provider's approval. 

Once your healthcare provider gives the go-ahead, you can slowly start strength training to rebuild your muscles and boost metabolism. At this time, you can also start to incorporate more vigorous forms of exercise like running or cycling, which can help you lose body fat. 

Listen to your body and take it slow, gradually building up to 150–300 minutes of moderate-intensity aerobic exercise (i.e. cardio) per week. When you feel ready, step up the intensity and duration of your workouts to promote weight loss. 

  You should also devote at least two days per week to strength training. This can include: 

• Weight lifting 

• Bodyweight exercises 

• Using resistance or elastic bands 

• Using resistance or weight machines at the gym 

Always progress at your own pace and stop any exercise that causes pain, discomfort, or unusual symptoms. Be sure to contact your healthcare provider if anything is concerning or you have questions.

3. Prioritize good sleep and less stress 

Being stuck at home post-op can get boring…fast. You might even start to feel stressed out. Combat boredom by exploring fun activities to engage your mind instead of mindless snacking (or stress eating) and calm you down. This can be a good time to take up a new hobby, such as reading, crocheting, or puzzling. 

You can also manage your stress with relaxation techniques like meditation, deep breathing, aromatherapy, or journaling. 

And do what you can to get a good night’s sleep. Research shows that when people get ample shut-eye (7–9 hours per night) regularly, they tend to lose more weight. Try these tips to improve your zzz’s:

• Stick to a consistent sleep schedule

• Create a calming bedtime routine

• Keep your room dark and cool

• Try to make the bedroom a place for sex and sleep only (though this can be hard during recovery) 

If menopause symptoms like hot flashes are making sleep difficult, talk to your provider about solutions.

4. Check in with your provider about your hormone levels

There are no two ways around it: Getting a hysterectomy disrupts your hormone levels. Lower estrogen levels post-op can lead to stickier fat around the midsection. Your fatigue and appetite may be influenced as well, making it tougher to eat a balanced diet and stay active. These effects will be more pronounced if your ovaries are removed. But they’re still possible with a partial hysterectomy because blood flow to the ovaries may decrease.  

If you’re feeling sluggish and hungry, ask your healthcare provider about hormone replacement therapy (HRT). Also known as menopause hormone therapy (MRT), these medications can help balance you out by restoring your estrogen levels. Beyond helping you feel more like yourself again, HRT can improve cholesterol levels. It can also redistribute some of the menopause-induced gains in body fat, so they’re less likely to sit around your belly. These medications may not be right for everyone and warrant an in-depth discussion of risks and benefits before deciding if they may be right for you.

5. Explore weight loss medication

While lifestyle changes are important, they may not get you all the way to your goal weight. In these instances, it’s worth chatting with your healthcare provider about other treatment options. If you have obesity or are overweight with additional weight-related health issues, weight loss medications may be an option. 

GLP-1 medications like Wegovy (semaglutide), Saxenda (liraglutide), and Zepbound (tirzepatide) work by slowing down your digestion, reducing your appetite, and boosting feelings of fullness. These effects can lead to significant weight loss when combined with diet and exercise. While these medications haven’t been studied specifically in people who have had hysterectomies, clinical trials in the general population have shown weight loss results ranging from 6% to nearly 21% over about 18 months.

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Weight gain after hysterectomy is common, but it doesn’t have to be permanent. With the right plan and a few lifestyle changes, you can maintain or lose weight while supporting your recovery.

• The average weight gain after a premenopausal hysterectomy without removal of ovaries is about 3 pounds, according to one study. Some women may gain more, while others may maintain or even lose weight. Weight-related changes post-op can vary depending on individual factors like age, the type of hysterectomy, and whether the ovaries were removed

• Various factors can contribute to hysterectomy-related weight gain. These include hormonal changes (especially a loss of estrogen), reduced physical activity, disrupted sleep, and increased stress. 

• Weight loss after hysterectomy is possible. Following a balanced, protein-rich diet, gradually increasing exercise (especially strength training), managing stress, and getting good sleep can all support weight loss. 

• Medical interventions may also help you reach your goals. Consider talking to your healthcare provider about whether options such as hormone replacement therapy and weight loss medication are right for you.