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 directly suggests endometriosis leads to weight gain. In other words, endometriosis lesions don’t directly cause you to store fat. 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. Instead, 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 actually gained fat! Truth be told, many of us may just look bigger due to swelling, water weight, or bloat.

To start, let’s dig in here.

First, are you really “fatter” with endometriosis?

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

For example, a wonderful reader sent me this photo below. She writes, “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 of days 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:

This means excess storage of fatty tissue anywhere on the frame. If you are gaining fat, you will be the same larger size from morning to night, as well as throughout the month. Think: consistently bigger.

Inflammatory Swelling:

When the immune system inflames an area of the body, swelling occurs. Think: swelling after a bee sting or an ankle twist. With endo, swelling can occur when a cyst ruptures or tissue damage is triggered, say from a lesion being provoked or scar tissue irritation. 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! Swelling is not fatty tissue: it comes and goes, so at times you may feel bigger than other times.

Fluid retention (water weight):

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 “fat” 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??”]. If your tummy feels uncomfortably full, you feel bloated, and/or you’re not having good, full bowel movements daily, consider this.

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!}

Weight Gain and Endometriosis Issues:

2) Estrogen dominance and endometriosis weight gain

3) Exercise deficiency and endometriosis weight gain

4) Thyroid and weight gain with endometriosis

5) Too many hidden calories

6) Blood sugar dysregulation and endometriosis weight gain

7) Constipation, gas, bloating and endometriosis “weight gain”

8) Fluid retention and endometriosis “weight gain”

9) Swelling and endometriosis “weight gain”

10) Core dysfunction and endometriosis weight gain.

Click on any of these links to learn more about weight gain, real or perceived, and endometriosis.