Following my last blog "5 Important Checkpoints on your Weight Loss Journey", I received the question if it is normal to gain weight after a hysterectomy. That is a really common question I receive, so I am combining research I found with my experience, with the intent to help you decide how to tackle this problem.
According to an article in the Journal of Women's Health the average woman gains 10 pounds after a complete or incomplete hysterectomy. Immediately after a complete hysterectomy the body goes into menopause. It is interesting to note that the average woman gains 5 pounds after going through menopause, which in general is a process than happens within ten years or less. This raises the question why there is a significant difference in how much weight women gain after a hysterectomy versus going through menopause naturally.
In order to establish how the complete or incomplete removal of the uterus effects your health, I first would like to list some of the reasons a hysterectomy is performed in the first place:
- Chronic Pelvic Pain
- Uterine Prolapse
- Persistent Vaginal Bleeding
This already sounds like you have been through a lot by the time you had the hysterectomy. My prayers go out to you and I hope that you are feeling much better now. In the same study mentioned above, the women taking part in this study already had a large component of lifestyle related conditions which led to the medical procedure to manage it:
- being overweight
- alcohol consumption
- diet high in saturated fat
- physical inactivity
These are not to say that they cause the conditions leading to the hysterectomy but make it more likely.
The surgery itself is a traumatic event and requires down time to heal. Even if you have a text book recovery there is inflammation and scarring, constipation, residual pelvic pain, as well as inactivity and possibly over eating during this period and following.
A great source of information is the Hysterectomy Association which contains questions and answers to common and uncommon issues with the subject, including definitions of the different treatments and surgeries.
For our purposes involving weight gain, I will make the distinction between procedures that keep the hormone producing ovaries intact versus procedures that completely or partially remove these organs. This causes a drastic drop in hormones, which is believed to be responsible for the slow down in metabolism related to the loss of muscle, after the ovaries are not producing hormones (progesterone and estrogen) anymore.
We know that there is a medical reason that you gained extra pounds and the question remains; what can you do about it?
First of all, education is key. If you did not fully understand the reason you had the procedure done and what exactly was done it is important that you speak to your gynecologist so you can understand better what can be done to help you.
Second, we cannot ignore the lifestyle aspect of that weight gain. The changes your body undergoes, will have an impact in several of your systems, including your digestion, your remaining reproductive system (if any), your remaining endocrine glands, as well as your cardio vascular system. This means that these changes have to be taken in consideration when choosing how you eat and how you move!
Although lifestyle changes cannot be avoided on your part, my third suggestion to you is to consult the help of the medical community mentioned. Building and maintaining a strong team around you, such as your gynecologist, endocrinologist, and/ or a dietitian, will make a big difference in your recovery and maintenance of your health.
Since lifestyle changes and modification as well as physical activity and medical exercise are my expertise, I can give you all the help you need within my scope. I hope I can answer some important questions for you.
Establish how many calories you need!
You can start by using an app on your phone or asking you physician or dietitian. There is no app that can take in consideration special conditions but you have to start somewhere. If you stick to the calories provided and you are gaining weight or no losing weight, the calorie amount may not be correct, yet. This is where you can come and talk to a health coach, a dietitian or a nutritionist, to get help looking over your food choices during the week. This can be a very useful tool to pin point foods that are often a reason for weight gain. Keep in mind that you may be eating all the right foods but the amounts are not balanced, yet.
Add physical activity to your regiment
Never begin or drastically change your physical activity without consulting with your physician first!
You don't need to belong to a gym as long as you can become and stay physically active in whatever environment works for you. If you are already physically active, it is time to have someone look over your routine because you are losing muscle mass faster than before and have to adjust your workout accordingly. In a gym setting we can establish body fat percentage and body mass index. With this information we can calculate approximately how much muscle mass you have versus fat mass. If your program is successful you should lose body fat and gain muscle mass. In many cases this means that you may not lose much weight but we are changing your body composition which in turn will improve your overall health.
The image below is a great visual on the difference between a 5 lbs piece of fat and a 5 lbs peace of muscle. 5 lbs of muscle takes up much less space than 5 lbs of fat. Muscle mass increases your metabolism as it continues to burn calories even at rest. Increased muscle mass also means a better blood supply to organs and tissues.
Too much body fat means an increase in stored energy which slows down your metabolism. Hormones regulate the storage or release of energy and your hormones have been altered. This is assuming that your ovaries are the only source of hormones your body does not produce anymore. Stress can lead to other endocrine glands, such as the adrenaline glands and the thyroid to struggle with production or distribution of hormones. This may further alter your metabolism and increase the challenge of weight management.
Embrace the changes and get to know your body better
Probably not what you want to hear right now and I really wish there was a magic pill to fix this for you. However, anything of value requires effort. This effort you put into your health is priceless and worth it. Take your time to go through the behavior modifications needed to establish new boundaries for yourself. Learn to listen to your body and don't take the easy road because it usually leads you back to the beginning. Please ask questions and do your research. You are the expert on your body and with your help we can find solutions!