A structured weight loss programme before endometrial cancer surgery showed promise as part of pre-surgery preparation, while larger trials are still needed.
- Weight loss before surgery was feasible with structured dietary and dietitian support
- The intervention was linked with fewer postoperative complications among women undergoing endometrial cancer surgery
- The findings highlight the potential role of prehabilitation in preparing women for endometrial cancer surgery
Endometrial cancer is the most common cancer of the uterus and develops in the inner lining of the womb. It occurs most often after menopause, and abnormal vaginal bleeding is a common early warning sign. Because the disease is often detected at an early stage, surgery is a key part of treatment for many women (1✔ ✔Trusted Source
Intentional weight loss before endometrial cancer surgery to support postoperative recovery (ENDO-CARE): a multicentre, feasibility randomised controlled trial in England
).
For women with excess weight, however, preparing for surgery can involve additional considerations, as obesity is associated with a higher risk of postoperative complications. This has raised interest in whether structured weight management before surgery could help patients become better prepared for treatment and recovery.
A trial in The Lancet Obstetrics, Gynaecology & Women’s Health examined whether intentional weight loss before surgery could help prepare women for the procedure.
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Endometriosis by the Numbers: 5 Facts You Should Know
- Endometriosis affects approximately 1 in 10 women of reproductive age worldwide (1✔ ✔Trusted Source
Intentional weight loss before endometrial cancer surgery to support postoperative recovery (ENDO-CARE): a multicentre, feasibility randomised controlled trial in England ). - An estimated 190 million women worldwide live with endometriosis.
- Diagnosis can take years—the latest study reported a median diagnostic delay of 7 years (2✔ ✔Trusted Source
Endometriosis ). - Up to half of women with endometriosis may experience infertility (3✔ ✔Trusted Source
Diagnostic delay in endometriosis: is there any progress? ). - In recent U.S. data, nearly one-third of women diagnosed with endometriosis had used fertility services (4✔ ✔Trusted Source
Endometriosis, Polycystic Ovary Syndrome, and Uterine Fibroids in Women Ages 20-49: United States, 2022-2023 ).
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Can Weight Loss Before Endometrial Cancer Surgery Reduce Complications?
- Who took part: 78 women with excess weight awaiting surgery for endometrial cancer; 72 were included in the final analysis.
- What did they receive: Routine care or a meal replacement weight-loss programme with dietitian support until surgery.
- How much weight did they lose: The intervention group lost about 5kg, compared with about 2 kg with routine care.
- What happened after surgery: Complications within 30 days occurred in 27% of the intervention group compared with 51% of the routine-care group.
- Was it safe: The programme appeared safe overall, with no serious adverse events reported among analyzed participants, although dizziness, headaches, constipation and diarrhea were reported.
- What did the researchers conclude: The approach was feasible and showed a promising reduction in postoperative complications, but a larger trial is needed to confirm whether weight loss actually improves surgical outcomes.
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Weight Loss Before Endometrial Cancer Surgery
Participants replaced usual foods with nutritionally complete meal replacements and received dietitian support until surgery. It was a structured approach rather than general advice about eating better.
How Preoperative Weight Loss May Affect Recovery
The lower complication rate is an important signal, but it does not prove that weight loss itself prevented complications. This was a feasibility trial, designed to establish whether a larger trial could be carried out.
Lead author Dimitrios A Koutoukidis and colleagues wrote, “The intervention had a favourable safety profile and no evidence was found for a reduction in fat-free mass or physical function.”
This indicates prehabilitation, or preparing the body before an operation, may have a role alongside standard cancer care when there is enough time and support.
Safety of Rapid Weight Loss Before Surgery
The intervention was not suitable for everyone. Participants reported dizziness, headaches, constipation and diarrhea, and two stopped because of adverse events.
Patients should not assume that rapid weight loss before surgery is something to start independently. The trial included dietetic support and medication review for some participants with diabetes or hypertension.
Why Endometrial Cancer Weight Management Matters
For someone newly diagnosed, the period before surgery can be stressful. When appropriate, structured weight management may become part of surgical preparation rather than being left until recovery.
What The Findings Mean for Endometrial Cancer Care
The evidence does not establish that every patient should lose weight before surgery. A larger trial is needed to determine whether intentional weight loss actually reduces postoperative complications.
If you or someone you care about is preparing for endometrial cancer surgery, ask the treating team whether nutrition and weight management are appropriate for that individual situation. A supported plan can make decisions clearer during an already demanding time.
Frequently Asked Questions
Q: Can losing weight before endometrial cancer surgery reduce complications?
A: Yes. In the trial, complications within 30 days occurred in 27% of patients in the weight-loss group versus 51% receiving routine care. Larger studies are needed to confirm the benefit.
Q: How much weight did patients lose before endometrial cancer surgery?
A: Patients in the meal replacement programme lost about 5 kg on average, compared with approximately 2 kg among those receiving routine care.
Q: Is rapid weight loss before endometrial cancer surgery safe?
A: The structured programme appeared to have a favourable safety profile, although some participants reported dizziness, headaches, constipation, or diarrhea. It was provided with dietitian support.
Q: Who participated in the weight-loss programme?
A: The study included women with excess weight who were awaiting surgery for endometrial cancer. Of the 78 women enrolled, 72 were included in the final analysis.
Q: Should patients try to lose weight on their own before cancer surgery?
A: No. The study evaluated a medically supported meal replacement programme, so the findings should not be interpreted as a recommendation for unsupervised rapid weight loss before surgery.
References:
- Intentional weight loss before endometrial cancer surgery to support postoperative recovery (ENDO-CARE): a multicentre, feasibility randomised controlled trial in England – (https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038(26)00156-1/fulltext)
- Endometriosis – (https://www.who.int/news-room/fact-sheets/detail/endometriosis)
- Diagnostic delay in endometriosis: is there any progress? – (https://pubmed.ncbi.nlm.nih.gov/42054959/)
- Endometriosis, Polycystic Ovary Syndrome, and Uterine Fibroids in Women Ages 20–49: United States, 2022–2023 – (http://efaidnbmnnnibpcajpcglclefindmkaj/https://www.cdc.gov/nchs/data/hestat/hestat121.pdf)
Source-Medindia