Can You Lose Weight After a Hysterectomy? Yes, Just Not in Week Two

Last updated on September 14th, 2026 at 08:11 am

Maybe you’re two weeks out, the scale says up nine pounds, and the only plan anyone gave you was “see how you feel.” Maybe you’re a year out, doing everything you did before, and the weight isn’t moving. Either way, nobody handed you a plan that takes the surgery into account.

Three different women are reading this. One kept both ovaries. One lost one. One lost both, and menopause started before the anaesthetic wore off. (Or you were already through menopause, and the hormone parts don’t apply to you.) Not sure which you are? Work out what was removed first. The advice is different for each of you.

Online you’ll find women who lost 40 pounds without trying and women who gained 30 doing everything right. Both are true, and neither tells you what will happen to you.

Will I gain weight after a hysterectomy?

Plenty of doctors, relatives and hormone clinics seem sure you will. Ask for the study behind it and the answer gets vague.

There is one, and it says less than they think. Researchers followed women for a year after a hysterectomy (ovaries kept) and compared them with women who had no surgery. On average the surgery group gained about two pounds more, which is small enough to be chance. What did stand out: more of them had a bad year, gaining ten pounds or more, and the risk was highest in women who were already heavier or whose weight had yo-yoed before.

There’s a likely reason for that. Women having a hysterectomy aren’t picked by coin toss. They’ve had years of fibroids, endometriosis or bleeding that wouldn’t stop. When British researchers accounted for what women weighed before their surgery, the difference afterward shrank to nothing they could be sure of, and an Australian study found the women were heavier before surgery rather than gaining more after it. That points away from the surgery itself and toward the fact that it was done on women who were already carrying more.

So “the surgery did it” is a weaker case than the clinic pages make. It may add a little for some women. Whether the condition behind the surgery did the rest isn’t settled either, but the extra weight was there before the operation.

If you kept your ovaries

The changes are small, and they’re not on the scale. A one-time survey that scanned women who’d had a hysterectomy and kept their ovaries found a little more fat, a little more of it around the middle, and a little less muscle than women who never had the surgery. A difference you would never spot in the mirror.

Over the long haul, the bigger question is health, not pounds. Women who keep their ovaries are diagnosed with obesity somewhat more often in the decades after, though they were already heavier going in. And a large Canadian study found heart and metabolic disease diagnosed more often in the years after a hysterectomy where the ovaries were kept, in women who had the surgery in their twenties and thirties. That’s a reason to take the plan seriously. It is not a verdict about your weight.

The other thing your ovaries can do after a hysterectomy is quit early. It happens to roughly twice as many women as it does without the surgery. If it happens to you, you join the next group without warning, so it pays to know the signs your ovaries are shutting down. The blood-flow explanation you’ll see a lot (the ovaries starve without the uterus) is still a theory, and the percentages quoted with it don’t trace back to a study that measured blood flow.

If both ovaries came out

Losing your ovaries puts you into menopause overnight, and across menopause fat gain speeds up, with more of it going to the middle in the studies that checked. What it does to the scale is less clear.

In the big American midlife study, women whose ovaries were removed put on weight a little faster than women who went through menopause naturally. An Australian study that scanned women two years after their ovaries were removed found something different: it did not find more weight, fat or muscle change than in women who kept theirs. The only thing that shifted was a small amount of fat deep in the abdomen, in an extra analysis the authors themselves called uncertain.

So far as the two agree, losing your ovaries changes where your body stores fat, and over the years it raises your risk of the health problems that go with that. Whether it adds pounds on its own is still unsettled. One study saw a little, the other didn’t find a difference, and neither can tell you what your scale will do.

Estrogen seems to soften even that. Among women who lost their ovaries at 45 or younger, the ones who never took it gained more over the following decade than the ones who did. Nobody was randomly assigned, so estrogen might be the reason, or the women who chose it might have been different to begin with.

The change you can’t see is in your bones. Women who lose their ovaries before menopause lose bone density fast in the first year or two, which is the other reason strength work stays in your plan. Losing your ovaries young changes your bones in ways you won’t feel.

If one ovary came out

The research skips this one. It is not surgical menopause, and the studies haven’t tracked women with one ovary separately. Women online do get told otherwise, so: one out is not both out.

Whichever group you’re in, a hysterectomy tends to land in the same years that women’s bodies start trading muscle for fat, surgery or no surgery. The scale doesn’t speed up while it happens. Which is why, by the end of this, you’ll be measuring something other than pounds.

Why is the scale up 10 pounds a week after surgery?

Mostly because it’s weighing fluid.

Women describe the same arc so often it could be printed on the discharge sheet, and isn’t. The first few days: up nine, twelve, fifteen pounds. That’s IV fluid and swelling. The next couple of weeks: down again, sometimes lower than before surgery, because you have no appetite, the uterus and any fibroids are gone, and if you were on hormonal birth control or a progestin, that’s gone too.

One woman’s uterus weighed 146 grams, about a baseball. Another was down 12 pounds by week two. The organ explains a third of a pound of a drop like that. Nobody weighed the rest, but fluid and a week of barely eating are the usual suspects.

None of that comes from a study. It comes from women writing it down online, which is where I found it.

So for these two weeks, the rules are short:

• Eat. The surgical nutrition guidelines say keep eating normally after surgery, and set no calorie target for a routine operation. The “15 to 20 calories per pound while healing” number going around online has no source I could find.
• Protein at the basic daily amount. That’s 0.8 grams per kilogram of body weight, about 55 grams for a 70-kilogram woman. More later.
• Fluids and fibre. Up to two litres a day, mostly water, and the fibre built up gradually. RCOG’s recovery leaflet pairs the two for a reason. Stool softeners in the first weeks are normal. Straining is the thing to avoid.
• Walk from the day you get home. Build toward 30 to 60 minutes a day by week two or three, and lift nothing heavier than a litre bottle of water. Both from the same leaflet.
• Leave the scale alone. No guideline says so, but women who’ve been through it say wait for the six-week visit, and a doctor quoted online sees women “compromise their recovery by undereating because the scale is up.”

Eating less while you heal isn’t discipline. It works against the one thing your body is busy doing.

Is my stomach bigger because of fat or swelling?

Between week two and clearance, four different things can be going on under your waistband, and only one of them is fat.

Swelling from the surgery itself, which comes and goes through the day (the famous “swelly belly” that shows up by evening). Constipation, common enough after a hysterectomy that the recovery leaflets tell you to expect it. Deep stomach muscles that may have gone slack while you healed. And the fat you had before, sitting on top of all three. A tight waistband can’t tell you which.

Telling swelling, bloating and fat apart takes more than a mirror, and none of it replaces an examination.

When can I lift again after a hysterectomy?

The number on your discharge sheet has less behind it than you’d think.

RCOG says light loads for the first two weeks, nothing strenuous until three or four, and back to your usual activity within four to six. The NHS says no heavy objects, “such as bags of shopping.” ACOG says not until your surgeon says. The bodies don’t agree on a date, because the trial that would settle it hasn’t been run.

What has been checked is pressure. When researchers put sensors inside women, standing up from a chair pressed on the abdomen about as hard as lifting a 13-pound weight off the floor, and RCOG’s own leaflet now says there is “no evidence” that normal activity is harmful. The litre bottle is a tradition more than a finding.

Your surgeon’s number still wins, because they saw the inside of you and the leaflet didn’t. Walk every day, and keep the lifting light until your surgeon says otherwise.

If both ovaries came out before menopause, this is also the window when hot flashes and broken sleep can start. They get their own treatment, and they change the sleep advice further on.

When can I start losing weight after a hysterectomy?

There’s no official date. Women who’ve done it mostly describe waiting until they were cleared and back to normal activity, then easing in, and your surgeon is the one who can say whether that fits you.

“Cleared at six weeks” often arrives with no plan attached. Women describe the same appointment: “my surgeon just sorta shrugged at me.” Pelvic physiotherapists have a staged version that fills the gap:

1. From about six weeks: low-impact. Walking with some pace, swimming once you’re allowed, cycling, gentle Pilates.
2. Weights rebuilt gradually. The physios say gradual; the women who’ve done it describe starting at a fraction of the old load and backing off if anything hurts. (The 25-percent-a-week ramp you’ll see online comes from them, not from any guideline.)
3. High-impact and anything competitive last, at three months or later.
4. A pelvic physiotherapist the moment anything pulls, leaks or presses downward.

The six-week and three-month marks come from the POGP physiotherapists’ booklet; the advice to see a pelvic physio when something pulls or leaks is what women and their physios describe online. RCOG says strenuous activity at three to four weeks; the physios say three months for anything high-impact. Two respectable bodies, two months apart. Your surgeon breaks the tie.

There’s no official date for starting a deficit. Women writing about it online mostly wait three to six months, which tells you what other people did, not what you should do. The person who can answer that is your surgeon, so make the appointment count:

• Am I eating enough for how I’m healing?
• Is deliberate weight loss appropriate for me yet?
• What does my lifting restriction include, in kilograms?
• Which symptoms mean stop and call?
• If I was on a plan before surgery, how do I adapt it?

If both ovaries came out, HRT may be on the table in this window. Weight is not what it is for.

When you’re ready for more than walking, getting back to exercise and then back under a barbell each have their own stages.

How do I lose weight after a hysterectomy?

The same way women lose it after menopause, because that is the closest research there is, and it’s good. In a year-long trial of 439 women, women who changed their diet lost a lot, women who only exercised lost a little, and women who did both lost the most and kept more of their muscle. Not all of it. In the trial that compared two reducing diets, both cost some muscle.

So food moves the scale, exercise decides what the lost weight is made of, and you want both.

The deficit. About 500 to 1,000 calories a day under what you burn, which the guideline pairs with one to two pounds a week. That’s the NIH’s long-standing guideline, and newer guidelines haven’t replaced the number. Very-low-calorie diets, under 800 a day, are a twelve-week tool at most, with medical supervision, not a plan. And expect the rate to slow. Obesity Canada puts it flat: “3,500 calories equals a pound” is not how bodies work, and weight loss is not a straight line.

Protein. More than the basic amount while you’re cutting, in the range of 1.2 to 1.6 grams per kilogram. For a 70-kilogram woman that is 85 to 110 grams a day, spread over meals at about 25 to 30 grams each, which is the amount that switches muscle repair on.

Protein alone won’t save your muscle, though. In the closest trial, 54 postmenopausal women dieting without exercise, the high-protein group lost as much muscle as the low. Protein plus strength work holds more of it, which is the whole reason the ladder ends at a barbell.

The plate. Canada’s Food Guide plate: half vegetables and fruits, a quarter protein foods, a quarter whole grains, and water as your drink. Three meals that each land roughly 25 to 30 grams of protein without a spreadsheet (a protein-rich snack closes the gap to the daily total): two eggs with a cup of Greek yogurt and berries; a can of tuna over a big salad with chickpeas; a palm-sized chicken thigh or a block of tofu with rice and a pile of roasted vegetables. Nothing needs to be labelled hormone-friendly to count as dinner.

Keto and fasting. Ways to eat less that some women keep to and some can’t. Keto hasn’t been tested in women after a hysterectomy or menopause specifically; fasting windows have. In a trial of women in their forties and fifties, eating in a set window helped, and eating in a window plus exercising helped about twice as much. If a window or a low-carb plate makes eating less feel easier, that is the whole of its magic. If it makes you miserable, drop it; the deficit was the part that worked.

Movement. The target once healed is the national guideline: 150 minutes a week of brisk walking or its equivalent, and strength on two or more days. Doubling the walking takes off slightly more, but the returns tail off fast past about four hours a week. Across a hundred trials, cardio was best for losing fat and lifting was best for keeping muscle. Doing more sets in the gym has not been shown to beat doing fewer. Two sessions a week you keep up beat five you keep skipping.

Not everyone can pick up a barbell. A bad neck, a bad knee, or a hysterectomy that also cleared out years of endometriosis can rule out half the standard exercises. If that’s you, a physiotherapist can build a strength routine around what your body can do, and being told to “just add strength training” isn’t advice until someone shows you how.

Measure the right thing. A tape around the waist: 88 centimetres, or 35 inches, is Health Canada’s line for raised risk. Once you’re cutting, weighing yourself weekly or daily helps, unless you have a history with eating disorders, in which case the tape and your clothes do the job. “Same weight, a whole pant size down” is a line you’ll see again and again from women a year out.

Sleep. Seven to nine hours, per the same Canadian guideline. When researchers got short sleepers to sleep more, they ate a few hundred fewer calories a day without trying. That was young adults, not women out of surgery, so treat night sweats as part of the weight plan without expecting a number from it.

If yours started when your ovaries came out, treating the sweats belongs in the plan.

Supplements. A pound or two at best across the trials, and a run of liver injuries from garcinia. That’s the review.

Did my hysterectomy slow my metabolism?

Almost half of the pages ranking for this question say yes, flat, and not one of them cites a study. Who knows what a hysterectomy does to resting burn; no study that checked it before and after the operation itself turned up.

The closest anyone has come is a drug experiment. Researchers switched off women’s ovaries with medication for a few months, gave half of them an estradiol patch to replace what the drug removed, and watched what happened to resting burn. On the placebo it dropped a little. On estradiol it didn’t drop at all. The same lab tried again a few years later and saw the same direction, too small to be sure of.

How much? Around 50 calories a day at rest, in that one experiment. Total daily burn fell in both groups, patch or no patch, so the picture isn’t as clean as “estrogen fixes it.”

What it does suggest: losing ovarian estrogen may lower resting burn a little, and replacing the estrogen may prevent that part. It says nothing about a fixed calorie penalty for having a hysterectomy, and it can’t rule out other changes in any one woman. The drop only showed up once ovarian hormones were switched off. A review of the studies that looked found not one where estrogen lowered resting burn.

Then there’s the famous “your metabolism drops 100 calories a day at menopause.” That number came from one 1990s paper, and the paper was retracted for fabricated data. Across thousands of people, calorie burn adjusted for body size holds fairly steady from 20 to 60, so age and body size explain far more of it than menopause does.

You may run into a chain of reasoning that goes like this: the uterus is gone, so the ovaries lose their blood supply, so estrogen drops, so your metabolism slows, so cortisol climbs, so even a GLP-1 medication won’t work on you. It reads like medicine. The people sharing it can’t say where it came from.

Take it one link at a time. The blood-supply idea is a theory, not a finding. The estrogen drop only happens if your ovaries stop. The metabolism slowdown rests on two small drug experiments in women whose ovaries had been switched off. One found a small drop at rest; the other pointed the same way but was too small to be sure of. And nothing ties cortisol or GLP-1 medication to any of it. If you see that paragraph, or a doctor repeats it to you, ask for the study. There isn’t one. If you want the long version, there’s a whole article on what does and doesn’t change your metabolism after surgery.

Will HRT help me lose weight after a hysterectomy?

Ask online and you get both answers with equal confidence: “HRT melts stomach fat” and “the patch made me gain, I quit.” Neither has the research behind it.

Trial after trial, pooled together, did not find an effect of HRT on weight either way. In a four-year trial, women on a patch and women on a placebo both drifted up a little, and the trial was not set up to compare the two. And the Australian ovary-removal study did not find a body-composition difference between the women on HRT and the women off it.

Where HRT might help is with where fat sits, not how much of it there is. One review found HRT users carrying somewhat less fat around the middle. That same review’s line is the one to keep: HRT “should not be marketed or prescribed for weight loss.”

What it is for: hot flashes, sleep, bones if your ovaries came out young, and the energy to train. Sleeping through the night without waking up drenched is a treatment goal all by itself, and it feeds everything else here. If you can’t take it, the plan still stands; it just has one fewer lever. Whether you should be on it at all depends on your age and whether your ovaries came out.

What if I was already losing weight before surgery?

Then the surgery lands in the middle of something that was working, and the fear is losing your place.

The women who’ve done it describe the same shape: maintenance and protein while healing, walking, then back to whatever was working once they were cleared.

If a GLP-1 medication is part of your plan, the advice on what to do before surgery changed in late 2024. Most people now keep taking it. If your dose is still going up, or you have nausea, vomiting or constipation, the guidance says to put off non-urgent surgery until that settles. Otherwise your team weighs it up individually, and that can mean pausing the drug or a liquid-only diet for the day before. That’s why you’ll hear every version from “stop four weeks out” to “missed one dose.” Get a written medication plan from your surgical team, and ask the same team when to restart; the guidance doesn’t say. Medication is one line on a longer list of things to sort out before surgery.

And the opposite reader: you lost 30 or 40 pounds after surgery without trying and are wondering if that’s fine. Fibroids weigh something, anaemia lifting gives you energy back, and coming off hormonal contraception changes appetite for a lot of women. All of it from women comparing notes, none of it from a study. Weight that keeps falling without you changing anything, especially with no appetite behind it, is a doctor’s appointment, not a win.

Why can’t I lose weight after a hysterectomy?

Because “be consistent” was never the diagnosis. If you’ve done the plan for a few months and the scale hasn’t moved, take a short list to your doctor instead of a longer list of things to try:

• What operation you had, when, and which ovaries you still have.
• Your weight over time, not just today’s.
• What you eat on a normal day and what activity you can manage.
• Every medication change since surgery. Gabapentin and HRT changes come up over and over in women’s accounts.
• Sleep: if you snore or wake unrefreshed, ask about a sleep study.
• Thyroid, and whether “low end of normal” is normal for you.
• Whether you’re eating enough to keep the plan up, and whether appetite has changed since surgery.

Then ask the better question: given my surgery, my symptoms, and what I’m already doing, what should we test or change? Leave with one thing to check and a date to review it.

Heal. Rebuild. Cut. The scale in week two was mostly reporting on fluid, and the scale at month four is reporting on fat, muscle, water and a bowel that hasn’t finished settling. Neither one was ever a verdict on you.

Common questions

Does removing one ovary put you into surgical menopause?

No. Losing one ovary is not surgical menopause, and the research hasn’t tracked this group on its own. The ovary you kept can still fail early, the same way both can after any hysterectomy, so the signs in the hormones article apply to you too.

Does an abdominal hysterectomy cause more weight gain than a laparoscopic one?

The one study that checked did not find a difference by route. The size of the incision doesn’t seem to set the size of the gain.

Is it true you gain five pounds after a hysterectomy?

That figure appears to be a menopause statistic with the wrong label on it, borrowed from what women gain across the menopause transition, surgery or not. No study ties five pounds to a hysterectomy.

How much does a uterus weigh?

Women who’ve asked report numbers like 146 grams, the weight of a baseball, though fibroids can add a lot to that. Either way, by their accounts a week-two drop is mostly water and lost appetite, not the organ.