Is hysterectomy related to obesity?
There is a very important study due to the number of patients it included, published in the 2013 Journal of Obesity. It was a study published by Dr. Gibson of the University of Pittsburgh. She compared two groups, a group of women who had natural menopause and another group of women who underwent surgery. All groups of women between 40 and 50 years of age were followed for approximately 10 years.
There were 1960 patients, of which 1,780 patients had natural menopause and 182 patients underwent a hysterectomy. Of the 182 patients, only 106 had a hysterectomy that involved both the removal of their ovaries. This study showed that patients who underwent a hysterectomy with removal of both ovaries had a higher risk or a greater tendency to obesity. She compared them based on body mass index.
For people unfamiliar with this formula, the body mass indicator is a mathematical equation that takes into account height and weight. If the result is between 18 and 24.5, it indicates that you are normal in weight. Beyond normal weight are the scales for overweight, obesity, and morbid obesity.
Ok going back to the central topic. Dr. Gibson showed in her study that hysterectomy and oophorectomy patients had an approximate gain of 0.21 per year based on their body mass index.
In comparison, women who had natural menopause had a 0.08 increase based on body mass index. That is, there was a greater trend in the patient with hysterectomy and oophorectomy. However, the author highlights at the end of the study that this cannot be applied to everyone due to the number of patients managed in the study. Another important detail that must be taken into account is that there were two very asymmetric groups: 1780 patients with natural menopause and only 182 who underwent surgery when the ideal would have been for the two groups to be similar in quantity.
Cause of Hysterectomy
However, this relationship between hysterectomy and obesity is not so simple to confirm. It depends on the type of patient, the type of hysterectomy, it often depends on the cause of the hysterectomy.
For example, if we talk about tumors in the endometrium, we already know that a risk factor for diseases in the endometrium is obesity. Endometrial tumor patients who will need a hysterectomy tend to already be overweight.
So, that persistence can be associated with obesity or a moment of obesity in time. Also, another very important factor and that must be emphasized is that generally the patients who undergo a hysterectomy are between 40 and 50 years old and in natural aging, there is a greater tendency to adiposity. Increases the amount of adipose tissue by the same factor of aging and in itself, there is a natural tendency to obesity.
So, what can be the causes of an increased risk of obesity in post-operated patients?
Anxiety is one of the causes. The fear you feel during the post-operative period added to the lack of information, that is why good communication with your treating doctor is very important.
Communication with your treating doctor is essential because each patient is a different world and the treating doctor is the one who is trained, he knows what surgical technique he used, what materials are used, and the one who knows your case best.
Medical rest is also another factor. During the medical rest, the patient is generally inactive at home in bed or sitting with a very noticeable reduction in physical activities.
So what happens if you keep eating the same way as you did before the surgery, You are going to gain weight because you are burning fewer calories.
So it is very important that you try to control your diet very well during recovery. Because if there is not going to be a natural tendency to gain weight, because you are doing fewer activities than you usually do.
Another factor no less important and associated with the previous one is diet. You have to have a healthy diet, try to reduce the intake of sweets and desserts during the post-operative period, and change it to a diet rich in fruits and vegetables.
That is not just for the postoperative hysterectomy. We must have a healthy diet for our lives, it has been seen that we can better control chronic diseases, cardiovascular diseases, diseases such as diabetes, high blood pressure, to name just a few, can be prevented. So a healthy diet is very important and in the postoperative hysterectomy much more and this will prevent you from having an excessive intake of calories.
It is also very important to drink water, we must not forget to drink water, even during the post-operative period. Usually, eight glasses of water a day are recommended, however, this can increase a little depending on the patient’s contracture and the activity that each person has. But it is important to have a healthy diet and also try to drink water frequently.
In relation to estrogens, It is quite true that estrogens can cause hormonal imbalances. It has already been proven that in a patient in a premenopausal stage who undergoes oophorectomy, estrogen levels can decrease from 120 picograms to 18 pictograms. This important decrease is of course going to bring consequences, symptoms in the patient who has been operated on. This decrease proves that 85% or 90% of premenopausal estrogen comes from the ovaries. But we also have to know that there is a lower percentage of estrogens that can be produced through aromatization.
Aromatization is when free androgens are transformed in adipose tissue, they become estrones. Estrones are the most common form of estrogen found in the post-menopausal stage. Androgens do decrease as well, but they do not do so in as dramatic a way as estrogens do. So we have to know that there is a natural decrease in androgens.
Androgens generally come from the adrenal gland of the ovaries and other peripheral glands, however, a decrease in androgens may be noted in oophorectomized patients or in post-menopausal patients.
So hysterectomy necessarily tends to be related to obesity if we take into account the age at which the hysterectomy is performed and take into account some statistical studies. We can see that there may be a tendency to link the operation with obesity, but it does not necessarily have to be the case.
It is important that you adopt healthy lifestyle habits so that you try to reduce that excess weight. If you have good communication with your doctor, have healthy habits, and follow everything to the letter, you do not have to gain weight.