Endometriosis and weight: understanding the biology and finding balance

Hormonal treatments, contraception and appetite

Many people with endometriosis use hormonal treatments to help manage symptoms and slow disease activity. These may include combined hormonal contraception, progestogen-based treatments or medicines that reduce oestrogen levels.

Hormonal treatments can affect people differently. Some may notice changes in appetite, body weight or fluid retention, while others experience little or no change. Fluid retention can sometimes create the feeling of weight gain even when body fat has not increased.

If you are concerned about weight changes while receiving treatment for endometriosis, it is worth discussing this with your doctor. Different treatment options may be available depending on your symptoms and individual circumstances.

Why losing weight can be difficult with endometriosis

Many people with endometriosis find weight loss more challenging due to the combined effects of pain, fatigue, sleep disruption and reduced physical activity.

Living with chronic pain can place stress on the body and may affect everyday habits that support weight management. Pain flare-ups can make exercise difficult, while poor sleep may influence hunger and fullness signals, making it harder to regulate appetite.

In addition, fatigue associated with endometriosis may reduce motivation and energy for meal planning, physical activity and other healthy routines.

These factors can create barriers to weight loss, even when someone is making a genuine effort to improve their health.

Can endometriosis cause weight loss or increase the risk of being underweight?

Yes, although it is less common. In some cases, endometriosis can affect the digestive system and lead to symptoms such as abdominal pain, bloating, nausea, diarrhoea or discomfort after eating.

For some people, these symptoms may reduce appetite or make eating more difficult, which can lead to unintentional weight loss. Significant or unexplained weight loss should always be discussed with a doctor, as it may require further assessment.

While weight gain tends to be reported more frequently among people with endometriosis, both weight gain and weight loss can occur depending on how the condition affects the individual.

How to lose weight with endometriosis

For people living with overweight or obesity and endometriosis, weight loss generally follows the same evidence-based principles as for anyone else: creating a sustainable calorie deficit through healthy eating habits, regular movement, good sleep and long-term lifestyle changes.

Because symptoms can vary from day to day, it may be helpful to choose approaches that are realistic and adaptable. Nutrition often plays a particularly important role when pain limits physical activity.

The goal is not rapid weight loss, but creating habits that support overall health while taking endometriosis symptoms into account.

The role of protein in satiety and muscle maintenance

Protein can be an important part of a weight loss plan because it helps promote fullness and supports the maintenance of muscle mass during weight loss.

Preserving muscle mass is beneficial because muscle tissue contributes to the body's energy expenditure. Including protein-rich foods such as fish, poultry, eggs, dairy products, tofu, beans or lentils as part of balanced meals may help support appetite control and overall nutrition.

Protein can also help reduce large fluctuations in blood glucose levels after meals, which may support energy levels throughout the day.

Gentle strength training to support metabolic health

When symptoms allow, strength training can be a valuable form of exercise for people with endometriosis. Building and maintaining muscle mass supports physical function, metabolic health and long-term wellbeing.

The most suitable type of exercise varies between individuals. Some people find that resistance machines, free weights, resistance bands or bodyweight exercises work well, while others may prefer walking, swimming or other low-impact activities.

Listening to your body and adjusting activity levels during symptom flare-ups can help make exercise more sustainable over time.

Medical weight loss treatment as support for endometriosis

For people living with obesity, medical weight loss treatment may be considered when lifestyle changes alone have not led to sufficient results. Any treatment decision should be based on an individual medical assessment.

Modern obesity medications, including GLP-1-based treatments, work by affecting the body's hunger and fullness signals. Many people experience reduced hunger, earlier feelings of fullness and less focus on food, which can support long-term weight loss.

For people with endometriosis who are also living with obesity, weight loss may contribute to improvements in overall health, mobility and quality of life. Reducing excess body fat may also influence levels of inflammation and hormone production in the body, although the effect on endometriosis symptoms varies between individuals.

At Yazen, medication is combined with support from doctors and other healthcare professionals. Treatment is tailored to each person's health, goals and circumstances and includes guidance on nutrition, physical activity, sleep and sustainable lifestyle habits. The aim is not only weight loss, but also improved health and long-term wellbeing.