a hysterectomy causes weight gain - fact or fiction?
Many women worry about weight gain after a hysterectomy. The topic is frequently discussed in social media groups with much strong sentiment. But what does the science say? Can a hysterectomy itself cause weight gain and is this something to worry about?
According to the research… it depends!
A medium sized study done comparing pre menopausal women having a hysterectomy to matched controls found that women having a hysterectomy did tend to have an average of 1.6kg weight gain compared to 0.9kg in their non hysterectomy controls over 1 year from baseline (pre surgery). But, the women having hysterectomies tended to be heavier to start, do less exercise, have more strenuous jobs, had had more pregnancies and were more often from lower socioeconomic backgrounds. The study also found that the women who put the most amount of weight on post surgery (10lbs+) weighed the most pre surgery. This means that it’s not necessarily the hysterectomy itself, but the fact that any surgery like this comes with a significant period of downtime where you need to rest. That extended period of rest, if not matched with reduced energy intake can lead to an increase in weight and so education and lifestyle modification is going to be important to prevent weight creep. The same sort of lifestyle modifications we would be looking at if surgery was not in the mix - diet, exercise, overall activity levels through the day, sleep and mental wellbeing.
Now surgical recovery is absolutely no time to try and loose weight, in fact your body needs to be slightly calorie excess in order to fund the metabolic responses going on in the body and avoid skeletal muscle catabolism. Bu the excess should be from protein. We actually need a slightly higher amount of protein intake during surgical recovery than normal, which many women don’t know or pay attention to. We tend to eat the lovely gifts of chocolate and biscuits given to us by well meaning friends and family and eat either what is easy to do ourselves or whatever is cooked for us, depending on our living situation. Not every woman has a loving partner at home to take care of them and so being organised pre surgery with healthy frozen means and organising deliveries of easy to prepare snacks such as fruit is key for nutritional success and weight maintenance after an operation like a hysterectomy.
So what this means for you? If you exercise and eat well and are a healthy weight going into your hysterectomy, then there is no reason for you to put on weight if you manage you energy intake well during the initial 6-12 weeks recovery phase. Assuming you have a normal, complication free recovery, you can build up a progressive programme of walking to be upto a good hour by week 6 so that your activity levels gradually increase and you will be able to increase your energy intake as you activity increases too. If you are going into your hysterectomy carrying more weight than you would like, then be aware that the enforced rest will see your energy needs drop. If you have time before your surgery to try and loose a little weight then this not only reduces your risk of putting on excess weight post surgery, but it also reduces your risk of complications during the surgery itself and can help you have a faster, better recovery. Being fit for surgery is a different blog post, but researchers have found that the fitter people are going into operations the less likely they are to have complications both during and after. A simple walking programme or finding a class you enjoy such as dancing can be all it takes.
References:
JOURNAL OF WOMEN’S HEALTH Volume 18, Number 5, 2009
a Mary Ann Liebert, Inc.
DOI: 10.1089=jwh.2008.1019
A Prospective Study of Weight Gain after Premenopausal Hysterectomy