Does Endometriosis Cause Weight Gain? An RD Explains

Endometriosis is a condition where tissue similar to the lining of the uterus grows elsewhere in the body, such as on the ovaries.

It affects 10% to 15% of reproductive-age women and people assigned female at birth.

The most common symptoms are chronic pelvic pain and difficulty getting pregnant.

Since endometriosis involves hormonal changes, such as excess estrogen, it can lead to weight gain in some cases.

Additionally, certain treatments for endometriosis, such as hormonal treatments or hysterectomy (surgical removal of the uterus), can lead to weight gain.

Read on to learn about the link between endometriosis and weight gain and nutritional and lifestyle strategies for managing weight gain with endometriosis.

Does Endometriosis Cause Weight Gain?

While weight gain is not a typical symptom of endometriosis, endometriosis can lead to weight gain.

This is primarily due to excess estrogen and certain endometriosis treatments, such as hormonal therapies and hysterectomy.

What is Endo Belly, and How Does it Relate to Weight Gain?

If you have endometriosis, you’ve likely experienced “endo belly” – the severe bloating that can lead to a swollen, distended abdomen.

However, while the bloating and swelling associated with endo belly may cause a temporary increase in weight or changes in how your clothes fit, it’s typically related to factors like inflammation, fluid retention, and digestive problems rather than an actual increase in body fat.

Factors Contributing to Endometriosis Weight Gain

There are several factors that may contribute to endometriosis weight gain, including hormonal changes, chronic pain and inflammation, digestive problems, medications, and a lack of physical activity.

Hormonal Changes

Endometriosis is linked to hormonal imbalances, particularly estrogen dominance.

Having too much estrogen maycan lead to increased fat storage and weight gain.

Chronic Pain and Inflammation

One of the main drivers of weight gain related to endo belly is fluid retention in the abdomen caused by inflammation, which can lead to temporary weight gain.

Digestive Problems

Another cause of weight fluctuations with endometriosis is digestive issues like constipation, diarrhea, and gas.

These symptoms may cause bloating and discomfort that mimics weight gain.

Medications and Other Treatments

Some treatments for endometriosis, such as hormonal therapies, can cause weight gain or changes in body composition. 

In severe cases of endometriosis, surgical treatment such as a hysterectomy may be the best treatment option.

People who have had a hysterectomy may be at a higher risk of gaining weight, especially in the first year after surgery.

Lack of Physical Activity

Endometriosis can be a very painful condition to live with. When you’re struggling with a flare-up of symptoms, you may be in too much pain to exercise or be physically active. Over time, this could lead to weight gain because you’re not expending as much energy.

Nutritional Strategies for Managing Weight with Endometriosis

While there is no specific “endometriosis diet,” several nutritional strategies may help manage endometriosis symptoms and promote weight loss.

Anti-Inflammatory Diet

Since inflammation is a significant component of endometriosis, eating foods that reduce inflammation may be beneficial.

Studies show that the Mediterranean diet, a popular anti-inflammatory diet, may also relieve endometriosis pain.

Additional sStudies demonstratealso show that the Mediterranean diet maycan help with weight loss. 

The Mediterranean diet includes:

• Fruits.
• Vegetables.
• Whole grains.
• Legumes.
• Nuts.
• Seeds.
• Olive oil.
• Fish.

It also includes small amounts of poultry, dairy, and eggs. Red meat is not typically eaten; when it is, it’s in small portions. 

Balancing Hormones Through Nutrition

A 2020 systematic review found that fiber may help reduce estrogen levels in the body.

Since excess estrogen can lead to weight gain, reducing estrogen levels may help with weight loss.

Here are some high-fiber foods to include in your eating plan:

‍

• Fruits (such as apples and pears with the skin, berries, avocados, bananas, and oranges).
• Vegetables (such as broccoli, Brussels sprouts, carrots, sweet potatoes with the skin, spinach, beans, cucumbers, bell peppers, and green peas).
• Whole grains (such as oats, barley, quinoa, brown rice, whole wheat bread and pasta, farro, bulgur, and popcorn). 
• Legumes (such as lentils, chickpeas, black beans, kidney beans, and split peas).
• Nuts and seeds (such as chia seeds, flaxseeds, almonds, pistachios, sunflower seeds, walnuts, and pumpkin seeds).

Supporting Gut Health

People with endometriosis often experience digestive issues like constipation, diarrhea, and bloating.

Therefore, eating foods to support gut health may be beneficial. 

Eating foods high in prebiotics (a type of fiber that feeds your good gut microbes) is one way to improve your gut health.

Here are some foods that contain prebiotics:

• Garlic.
• Onions.
• Asparagus.
• Leeks.
• Dandelion greens.
• Underripe bananas.
• Apples (with skin).
• Berries.
• Avocado.
• Oats.
• Barley.
• Wheat bran.
• Lentils.
• Chickpeas.
• Kidney beans.
• Black beans.
• Flaxseeds.
• Chia seeds.

Fermented foods can also support gut health, and regularly eating fermented foods is associated with weight loss.

Here are some fermented foods to try:

• Yogurt (with live cultures).
• Kefir.
• Sauerkraut.
• Kimchi.
• Pickles (fermented).
• Tempeh.
• Miso.
• Natto.
• Kombucha.

Fermented foods can have a strong flavor.

If you’re not used to eating them, try adding them to another food you enjoy.

For example, add kefir to a smoothie or sauerkraut to a sandwich or wrap.

Adequate Hydration

Getting enough fluids maycan help with constipation, which is common with endometriosis.

Since constipation can lead to bloating, which can mimic weight gain, managing constipation can be beneficial.

Some sStudies also demonstrateshow that increased water intake is associated with weight loss.

Lifestyle Tips for Managing Weight with Endometriosis

In addition to nutritional strategies to manage weight with endometriosis, several lifestyle changes may also be beneficial. 

Gentle Exercise and Movement

While high-intensity exercise may be challenging for people with endometriosis, gentle exercises can still provide benefits.

Here are some low-impact exercises to try incorporating into your routine:

• Yoga, especially restorative or Hatha yoga.
• Swimming. 
• Walking.
• Gentle stretching.
• Low-impact strength training using resistance bands.
• Stationary cycling.
• Water aerobics.

‍

If you haven’t been exercising regularly, start slowly and gradually increase the frequency and intensity as your fitness levels increase.

Stress Management

Stress can significantly impact eating habits, with some people tending to eat more when they experience stress.

‍Guidelines for adult weight management suggest that stress management should be a key component of any weight management plan.

If you’re experiencing significant stress, speaking with a therapist who can help you develop positive coping strategies may be helpful.

Quality Sleep

Some studies suggest that not getting enough sleep or having poor sleep quality is associated with weight gain.

The CDC recommends that most adults sleep between seven and nine hours each night.

The following strategies may improve your sleep quality:

• Go to bed and wake up at the same time each day.
• Keep your bedroom at a comfortable temperature.
• Switch off your electronic devices at least 30 minutes before bedtime.
• Avoid caffeine after lunch.
• Exercise regularly.

When to Seek Professional Help

If you have endometriosis, it’s important to seek professional help if you experience any of the following symptoms:

• Severe pelvic pain.
• Heavy or irregular periods.
• Pain during sex.
• Painful bowel movements.
• Painful urination.
• Difficulty getting pregnant.
• Chronic fatigue.
• Worsening symptoms.
• Mental health concerns.
• Lack of relief from medications.

Takeaway

Hormone imbalances and certain endometriosis treatments may lead to weight gain.

In addition, fluid retention caused by inflammation and digestive issues can lead to temporary weight gain. 

Fortunately, there are many strategies to help manage these weight changes, such as the Mediterranean diet, eating more fiber, eating more fermented foods, and drinking enough water.

Lifestyle changes like incorporating gentle movement, managing stress, and getting good quality sleep can also help with weight management.

If you’re struggling with the symptoms of endometriosis, it’s important to seek professional help to ensure your condition is managed properly.

How a Dietitian Can Help

A registered dietitian can play a key role in helping you manage endometriosis symptoms and weight gain.

They can recommend anti-inflammatory foods, help you identify and manage food intolerances, and provide guidance on balancing hormones through nutrition.

A dietitian can also help you develop a weight management plan that considers your goals, preferences, symptoms, and lifestyle.

You can find a dietitian who accepts insurance through Nourish