Can Endometriosis Make You Gain Weight? What Experts Say About the Complicated Connection

If you have endometriosis, you know that the symptoms can be unpleasant, from common ones like intense cramps, fatigue, and excessive bleeding to “silent” symptoms like fertility issues and ovarian cysts. If, on top of all that, you also feel like you’ve gained weight due to endometriosis, know that you’re not alone. Bloating (aka endo belly) will often make it seem like you’re putting on weight in your midsection, but true weight gain might be happening too — though it may not be directly related to endometriosis.

“Endometriosis itself does not cause weight gain, but some women with endometriosis experience weight gain due to some of the factors associated with the condition,” explains Dr. Victoria Scott, a urologist specializing in pelvic floor disorders with the Down There Doctors.

Endometriosis is a complicated condition that occurs when the tissue that lines the uterus grows outside the uterus itself. It can impact your pelvic organs, ovaries, the lining of the abdominal cavity, and more, and just because it may not directly cause weight gain, doesn’t mean there’s not a link between the two. That’s especially true when you consider that, like so many other conditions that effect women and AFAB (assigned female at birth) people, endometriosis has been heavily under-studied, meaning that there’s still a lot we don’t know about it. With that in mind, SheKnows spoke with all three of the Down There Doctors — Scott, urogynecologist Dr. Karyn Eilber, and urologist Dr. Jennifer Anger — to discuss what we currently know about the connection between endometriosis and weight gain.

Endometriosis Weight Gain: Possible Causes

People have reported weight gain with endometriosis, but as far as we currently know, endometriosis doesn’t directly cause people to gain weight. That said, a few issues related to endometriosis could contribute to weight gain.

Difficulty staying active: Endometriosis is extremely painful, and that can impact all areas of your life, including your level of activity. “Some women may gain weight because they have a hard time exercising or staying active due to pain from endometriosis,” Scott explains. If you’re bedridden and experiencing intense pain, exercise probably isn’t your top priority.

Mental health struggles: Chronic pain is heavily associated with depression, with a 2003 study finding that people with chronic pain are three times more likely to have symptoms of depression. People with depression are also more likely to overeat or not exercise, according to a 2022 study, which can lead to weight gain over time. As Scott explains, “The emotional impact of coping with chronic pain from endometriosis may lead to depression, a sedentary lifestyle, poor eating habits and stress, which can all lead to weight gain.”

Hormone imbalances: People with endometriosis typically produce high levels of estrogen and experience hormonal fluctuations, according to studies, which can lead to weight gain over time. Hormonal weight gain could also result from some hormonal treatments for endometriosis, such as the birth control pill, which are “associated with a small amount of weight gain,” Anger says. In those cases, she notes, the trade-off might be worth it for some. “Most women would trade pain for a little bit of weight gain any day!”

Does Endo Belly Cause Weight Gain?

Painful bloating, often called endo belly, is another common and unpleasant symptom of endometriosis. (study) While bloating isn’t the same thing as weight gain, you might see your abdomen looking more swollen than usual and wonder if you’ve gained weight.

Endo belly doesn’t have anything to do with your weight, though. It happens when endometrial growths irritate the lining of your abdomen, Eilber explains, causing inflammation and bloating. “Similarly, endometriosis involving the rectal area can cause pain and inhibit normal bowel movements, further causing bloating,” she says.

Research has shown that an anti-inflammatory diet (think: plant-based and low in sugar and gluten) can help treat endo belly flare-ups.

Managing Weight With Endometriosis

“If you are experiencing weight gain with endometriosis, it is important to consider all possible causes, since it is unlikely to be due to the disease itself,” says Scott. Lifestyle factors like diet and exercise may be playing a role, so it’s a good idea to make concrete changes in those areas if weight loss is a goal — while acknowledging that, as we said, options like regular exercise might not be viable if you’re dealing with intense chronic pain.

Treating your endometriosis itself may also help. “Successful treatment of endometriosis means a freedom from pain that occurs every month,” Anger explains. “This can lead to more exercise and a healthier pain-free lifestyle, as well as weight loss.” Treating endometriosis isn’t a straightforward process, however, and there’s no cure for the condition. Treatment options include pain medication, laparoscopic surgery to remove growths, and a hysterectomy with or without removing the ovaries.

Whether or not you’re dealing with weight gain alongside endometriosis, you’ll want to be in close contact with your doctor to discuss your symptoms, concerns, and treatment options. “If you feel that your gynecologist is not able to adequately address all of your symptoms (i.e., emotional, gastrointestinal, pain management, urinary),” Scott says, “be sure to ask for referrals to see other doctors too for additional help.”

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