No, according to a British study published in this week’s Maturitas. Removal of the uterus, with or without removal of the ovaries, is unlikely to lead to weight gain.
The investigators used data from two British prospective health studies that enrolled over 6,000 women born in 1948 and 1956 and followed them longitudinally throughout their lives.
Although women who had a hysterectomy had higher BMI and waist circumference in middle age than women who had not had this surgery, this was because they were already heavier to start with, not because they had had a hysterectomy. After surgery, these women merely continued on their previous trajectory of weight gain, as did their same-sized cohorts who had not had the surgery.
In unadjusted analyses there was a difference of 1.18 kg/m2 (95% CI: 0.64, 1.74) in mean BMI and of 2.72 cm (1.45, 3.99) in waist circumference at age 44–45 years between women who had undergone hysterectomy and those who had not in the 1958 cohort, and differences of 0.76 kg/m2 (−0.05, 1.57) and 0.34 cm (−1.58, 2.26) at age 43 years and 0.81 kg/m2 (0.14, 1.49) and 1.45 cm (−0.15, 3.05) at age 53 years in the 1946 cohort. These differences attenuated and were no longer significant after adjustment for pre-hysterectomy BMI and confounders. There was no strong evidence of variation in associations by oophorectomy status, timing, route of or reason for procedure. (italics mine)
Such is the value of longitudinal objectively measured data. Although previous cross sectional and cohort studies have shown weight gain after hysterectomy, none of these controlled as well for pre-hysterectomy weight, and none had the kind of objective measure of pre-hysterectomy weight used in this study, where subjects had nurse visits for measurement of weight and other vital signs throughout their life.
It is known that menopausal women begin to shift their weight to the middle, and that hormone replacement prevents this change. In this study, however, hormone replacement only accentuated the difference in BMI between women who had hysterectomies and those who did not. We do know that obese women have more hot flashes than thinner women, and perhaps they ended up using more HRT. That’s just a thought on my part.
Some other thoughts 
So, women who were heavier to start with end up with more hysterectomies.
Although this study did not address the question, one has to ask – why? What is it about higher weight that leads to hysterectomy?
One factor could be that obesity raises the risk for endometrial cancer. Other risk factors for endometrial cancer are diabetes, hypertension and lifelong irregular menses such as those experienced by women with polycystic ovarian syndrome, all conditions linked to obesity. Obesity is also associated with higher rates of uterine fibroids and prolapse of the uterus, two common causes for hysterectomy. In the study reported here, women having hysterectomies for reasons of fibroids and prolapse had higher BMI’s, while those with cancer had lower BMI’s.
It was interesting to me that women born later in this study had less hysterectomies by their mid 40’s than their older counterparts, suggesting that they and their physicians were finding ways to avoid surgery to treat their conditions. Indeed, we now have a number of good non-surgical interventions for fibroids, so that less women should have to have surgery for this indication as time goes on.
Unfortunately, this study also showed that women of lower socioeconomic status had higher rates of hysterectomies, making me wonder if they had access to the kinds of treatments throughout their reproductive life that could have prevented their surgery.
Bottom Line
If you are deciding whether or not to have a hysterectomy, concern about weight gain related to the surgery does not appear to be important factor in your decision-making. That leaves you more time to really talk to your doctor about what your options are and what’s best for you, surgery or not.
_________________________________________________
Venus at the Mirror and Three Graces. Paul Rubens (1577-1640)
There are tons of other obstacles that women have to deal with while doing through cancer. For a lot of women, dealing with chemo related hair loss can deal a major blow to their self esteem. I work as a community ambassador with Pantene Beautiful Lengths and Million Inch Chain and are trying to gather 1 million inches of hair for these women dealing with that. Our goal is to try and give these women confidence by giving them back the hair that they lost. I am asking all of you out there to help this cause by donating their hair, or pledging to donate their hair to this amazing cause. If you would like more information please visit this website let’s get every inch of hair that we can get! http://www.beautifullengths.com/en_US/million_inch/million_inch_qa.jsp
I lost weight after my hysterectomy. The reason–I felt better, so went out walking rather than curling up on the couch when I got home.