Causes of belly fat after hysterectomy

Hysterectomy recovery can be challenging, and weight gain or an increase in belly size doesn't make it any easier. But healthy eating, weight-loss-friendly dieting, and exercise can help.

Avatar illustration of a woman with increased belly fat

Key takeaways:

  • It is common for some people to experience increased weight, belly fat, or a protruding belly after a hysterectomy.
  • Causes of belly fat after hysterectomy include internal organ swelling, damage to abdominal muscles and ligaments, and low estrogen levels (for hysterectomies that involve removal of the ovaries).
  • Doing light abdominal exercises and eating healthy, low-calorie meals can help with losing belly fat after a hysterectomy.

When a person undergoes a hysterectomy, it's not unusual for them to gain weight and get more fat around their tummy. In some cases, the increase in belly size is not exactly due to fat accumulation but rather due to swelling of internal structures in the pelvis.

Doctors perform hysterectomies for different reasons. Depending on the type of hysterectomy performed and its purpose, it can affect weight and cause fat accumulation. A study showed that people who had hysterectomies weighed more after the procedure and were at a high risk of gaining weight in the first year after the surgery.

Because belly fat is a common challenge among people who have undergone this procedure, getting rid of it is a top priority. To get rid of hysterectomy-induced belly fat, it's important first to understand its causes.

Possible causes of belly fat after hysterectomy include:

1. Damage to abdominal muscles and ligaments

Abdominal muscle or ligament damage is one possible cause of increased belly fat or a saggy stomach after a hysterectomy. Hysterectomy can cause muscular and anatomical changes, especially in the lower abdominal area. Ligaments and muscles like the transversus abdominus hold the uterus in place.

These structures also help stabilize the core (midsection) and maintain internal abdominal pressure, but when they are severed during a hysterectomy, they can lose their function or become weakened. This can lead to a shortened, thick midsection or a protruding belly after a hysterectomy.

2. Internal swelling

When organs inside the abdomen or pelvis swell after a hysterectomy, it can make the stomach look like it's sagging. Your belly will be swollen after a hysterectomy; some people misinterpret this as belly fat. It can take weeks or months for the swelling of the internal lower abdominal and pelvic structures to reduce and return to normal.

3. Hormonal changes

Changes in reproductive hormones like estrogen is one of the primary causes of belly fat after a hysterectomy. If your ovaries were taken out during a hysterectomy, your hormone production would change, and you would experience menopause symptoms. This is also called "surgical menopause" because the ovaries that secrete estrogen hormones have been removed.

The absence or reduced estrogen production is similar to what happens during menopause, when the body secretes only a small amount of estrogen.

Reduced estrogen levels have been linked to increased belly fat. According to a 2014 review study, sex hormones play significant roles in body fat distribution. The study linked the absence of estrogen to weight gain and increased abdominal fat in menopausal women.

What is a hysterectomy?

A hysterectomy is a surgical procedure where all or parts of the uterus (womb) are removed. It is often performed to treat medical conditions affecting the uterus or organs surrounding it, such as the fallopian tube, cervix, and ovaries.

The primary target of a hysterectomy procedure is the uterus, which is the hollow, muscular organ where a fertilized egg implants and develops into a fetus during pregnancy. A person who has a hysterectomy won't be able to carry a pregnancy after the surgery.

A hysterectomy can be done for different reasons, such as:

  • Painful fibroids
  • Cancer of the uterus, ovaries, or cervix
  • Severe pelvic pain
  • Uterine prolapse (a condition where the uterus falls or drops through the cervix and comes out from the vagina)
  • Endometriosis (a disorder where the cells or tissues that normally grow in the inner lining of the uterus grow outside it)
  • Adenomyosis (a condition where the inner lining of the uterus grows into the muscles of the uterus)
  • Pelvic inflammatory disease

Types of hysterectomy

There are different types of hysterectomy, and they include:

1. Partial abdominal Hysterectomy

In a partial hysterectomy, the entire uterus won't be removed. Only a portion will be removed. In some cases, the doctor might leave the cervix intact. The cervix is the lower, narrow end of the uterus that forms a connection or canal between the uterus and the vagina.

2. Total abdominal hysterectomy

A total hysterectomy entails that the entire uterus is removed along with the cervix. It is advisable to keep going for regular pelvis examinations, even with the removal of the cervix.

3. Total hysterectomy with bilateral salpingo-oophorectomy

In this type of hysterectomy, the surgeons remove the uterus and cervix, the ovaries (oophorectomy), and the fallopian tubes (salpingectomy). This is the type of hysterectomy that causes menopausal symptoms in women who have not yet reached the age of menopause.

4. Radical hysterectomy with bilateral salpingo-oophorectomy

Surgeons often perform this type of surgery when cancer is involved, e.g., when a person has uterine, ovarian, or cervical cancer. They may have to remove the uterus, the fallopian tubes, the cervix, the ovaries, some lymph nodes, the upper part of the vagina, and some surrounding tissues.

Factors that can affect weight after hysterectomy

Several factors can affect weight after a hysterectomy, and they vary from person to person. Some of the factors include:

  • The type of hysterectomy performed: The type of hysterectomy you will undergo depends on why it is performed. However, some types of hysterectomy affect weight gain more than others. For example, a hysterectomy in which the ovaries are removed can cause reduced estrogen production, leading to weight gain.
  • Your weight before the surgery: People who were overweight before a hysterectomy are more likely to gain weight after the procedure. The higher your weight before the procedure, the more likely you are to gain weight after it. Also, staying physically inactive after the hysterectomy procedure may increase the chances of weight gain.
  • How fast you recover: After a hysterectomy, it may take 4-6 weeks before you return to normal and resume your normal activities. Staying in one place for a long time without performing any physical activity can impact your weight, leading to weight gain. The time it takes to heal after a hysterectomy varies from one person to another. A more invasive hysterectomy will require more time to heal, and people who undergo such a procedure might gain more weight.
  • Lack of physical activity: People who have had a hysterectomy may not be able to perform any exercise after the procedure. This is due to the pain and discomfort that accompany such a procedure. Not being physically active can cause an accumulation of fat, leading to weight gain.

Benefits of abdominal exercises after hysterectomy

Similar to belly fat massage, doing some abdominal exercises after a hysterectomy may help improve your overall well-being. The following are the benefits of abdominal exercise after a hysterectomy:

  • Abdominal exercises like kegel exercises help strengthen pelvic muscles.
  • Abdominal exercise after a hysterectomy helps flatten and tone the lower belly muscles.
  • They help promote good standing and sitting posture.
  • They help strengthen your abdominal muscles and the muscles of your lower back.

Best diet for losing belly fat after hysterectomy

Belly fat is common after a hysterectomy. However, there are things you can do to promote belly fat loss, including eating healthy foods.


Fruits are a good option to take after undergoing a hysterectomy procedure. A variety of fruits exist, like oranges, limes, apples, pineapples, bananas, avocados, blueberries, etc., and they all have great health benefits. You can consume them raw or as detox smoothies.

Eating enough fruits will not only keep you from gaining weight but will also lower your chances of developing other chronic conditions, such as cardiovascular diseases. This is also one of the natural ways to lose weight fast.


Vegetables can help fight inflammation in the body because they are rich in antioxidants. Vegetables are also a good source of fiber, and fiber is great for gut health. Vegetables also have other functions, like improving skin and reducing the risk of heart disease, and they can help regulate your blood sugar.


Eating beans as your top protein source will reduce your chances of gaining weight or belly fat. Beans are proteins that are low in fat and have a low glycemic index. Beans are also a good source of fiber. Eating beans will help you feel full for a long time, which will help you control the amount of food you consume.

Whole grains

If you want to lose weight or belly fat, it is best to stick with whole grains instead of refined grains. According to some observational studies, eating a lot of whole grains lowers your risk of gaining weight.

Taking whole grains can help you lose weight and reduce belly fat after a hysterectomy procedure. Examples of whole grains include whole rye, wild rye, buckwheat, brown rice, popcorn, whole wheat, whole oats, and corn.

Wrap up

Belly fat is common after a hysterectomy procedure. Some factors that can cause increased belly fat or a protruding belly after a hysterectomy include changes in muscles, ligaments, anatomy, and hormones.

Adjusting your lifestyle and dietary choices can help with weight loss and burn belly fat after a hysterectomy. However, it is best to stick with light exercises. You can work with your medical team to find a fitness expert who can help you lose belly fat without getting in the way of your healing.