Does Endometriosis Cause Weight Gain? No... but kind of yes

Endometriosis is a complex and often misunderstood condition that affects millions of women worldwide. Characterized by the growth of endometrial-like tissue outside the uterus, it can lead to a variety of symptoms, including pelvic pain, infertility, and menstrual irregularities.

Among the numerous questions surrounding endometriosis is whether it can cause weight gain. Truth be told, there’s really no research that suggests any links between endometriosis and weight gain. In other words, endometriosis lesions don’t directly cause you to store fat. Actually, research shows the opposite: that women with endo are more likely to be lean!

If this doesn’t depict your own story, you’re not alone. Many sufferers feel like their weight gain is aligned with their endo.

Unfortunately, this is why I see a LOT of women googling “how to lose weight with endometriosis,” only to land on sites that describe how low-fat, calorie-restricted diets are great. Ummm, no thanks. When we have chronic inflammation, immune dysfunction, pain, stress, and other issues, we do not need to restrict calories or fat. Rather, we need the most nutrient-dense diet known to humankind, and that won’t come from rice crisps and iceberg lettuce.

Not to mention not all of us have actual fat gain! In fact, many of us may just look bigger when, in fact, it’s due to something else.

First, is it even weight gain you have with that endometriosis?

Sure, you may have needed to buy pants two sizes bigger, but is that due to fat, water retention, swelling, gas, or even constipation? The difference is important to know!

For example, a wonderful reader sent me this photo below. She write, “I have stage 4 endo with two large bilateral endometriomas. On the right, a cyst had ruptured, which always causes a lot of swelling for me. I’d been stuck at home eating whatever I had left in the pantry for a couple day’s because I was in too much pain to drive to the store. I was on my period in both of these photos. The one on the left was taken after I slept, the one on the right just before bed. It’s wild—I don’t even look like the same person.”

So let’s get a better understanding of the many ways endometriosis can make it “look like” we gain weight, be it fat or something else.

Fat: excess storage of fatty tissue anywhere on the frame. If you are definitely gaining weight, you will be larger (than before) when you wake up and when you go to sleep, as well as throughout the month. Think: consistently bigger.
Inflammatory Swelling: When the immune system inflames an area of the body, swelling can ensue. Ever had swelling after a bee sting or an ankle twist? With endo, swelling can occur when there’s any tissue damage triggered, say from a lesion being provoking or growing, or scar tissue issues. I know in my history, I had swelling after ovulation that made my lower tummy tender to the touch, and you could visually see it protruding. Thanks inflammation for this! Swelling comes and goes, so at times you may feel bigger than other times.
Fluid retention: consider this water weight, which definitely can look like weight can. And you can have fluid retention anywhere on the body. If you are on certain medications, it may be your face; if you have diabetes, it could be your legs; if you’re dehydrated (lots of caffeine/salt/alcohol, or low water intake), you could be a little puffy all over; if you have endometriosis, it could be your pelvis or tummy, which now may be puffy or resemble a spare tire. Annoyingly, weight will show up on the scale and in the mirror, and it can be transient or stick around depending on where the water weight is coming from, so it may be hard to differentiate between fat and water weight at first.
Gas/Constipation: This is a tricky one! As someone who has dealt with both serious gas accumulation and constipation (from methane SIBO), I can attest that I’ve felt pretty darn round at times… all of which petered out after I figured out how to not have gas and constipation. But seriously, it even fooled me! [me looking in mirror: “why am I gaining weight??”].

Understanding the differences between these issues will help you figure out if you’re actually gaining fat, or if you have other issues going on with inflammation or digestion.

Of course, most of you may be unsure which issue you are dealing with, so read on for numerous clues to help you sleuth out what’s going on with your body. Below are some of the bigger issues I see with weight gain and endometriosis

{coming soon! Click the links as they become live!}