Fibroids, also known as uterine leiomyomata, are common benign tumours that develop in the uterus, primarily affecting women of reproductive age.
While fibroids are not cancerous, they can cause significant symptoms, including heavy menstrual bleeding, pelvic pain, anaemia, and bladder or bowel dysfunction.
…Although many fibroids remain asymptomatic, around 25% to 30% of women with fibroids experience considerable discomfort…
Obesity and Fibroid Growth
Obesity is a complex, chronic disease characterised by excess body fat, which is hormonally active. In women of reproductive age, obesity has been shown to increase the risk of fibroids in several ways:
- Local Oestrogen Production
Fat tissue contains the enzyme aromatase, which converts androgens (male hormones) into oestrogen. Higher body fat increases oestrogen levels, directly stimulating fibroid growth. Fibroid cells have oestrogen receptors, so increased oestrogen encourages them to multiply.
- Insulin Resistance and Growth Factors
Obesity often causes insulin resistance, where the body’s cells do not respond well to insulin. This results in higher insulin levels, which can increase the production of insulin-like growth factor-1 (IGF-1), which promotes fibroid cell survival, growth and the formation of dense, scar-like tissue.
- Chronic Inflammation
Obesity creates a persistent low-grade inflammatory state which contributes to fibroid growth. Fibroids in an inflammatory environment release cytokines such as IL-6 and TNF-α, which increase tumour size and stiffness. Inflammation also promotes new blood vessel formation that supplies oxygen and nutrients to fibroids, helping them grow larger.
Research and Evidence
…A recent meta-analysis involving 325,899 women and 19,593 fibroid cases found…
- Obesity increases fibroid risk by 19%.
- Women with the highest BMI had 19% higher odds of fibroids.
- Significant weight gain since age 18 increased risk by 26%.
Practical Strategies to Manage Fibroids
While obesity is a key factor in the development of fibroids, certain interventions can help manage or reduce their impact:
- Weight Management and Physical Activity
Sustainable weight loss and regular exercise help reduce inflammation and improve insulin sensitivity, which can slow fibroid growth. Though this approach cannot cure fibroids, it can help manage their severity.
- Hormone-Targeted Medications
Medications such as combined oral contraceptives, levonorgestrel IUDs (which can reduce bleeding), and GnRH agonists or antagonists (which reduce oestrogen and progesterone signalling) can temporarily shrink fibroids and alleviate symptoms.
- Imaging and Monitoring
Regular pelvic ultrasounds help track the number and size of fibroids, guiding treatment and ensuring early intervention when necessary.
- Whole-Health Approach
Addressing metabolic conditions such as high blood pressure, elevated cholesterol, and diabetes can improve overall health and reduce fibroid burden. Additionally, managing stress, prioritising sleep, and maintaining a balanced diet can support metabolic health and help treat iron-deficiency anaemia caused by heavy bleeding from fibroids.
Summary
Obesity contributes significantly to fibroid prevalence through hormonal imbalances, insulin resistance, and chronic inflammation.
…As fibroid rates continue to rise globally, especially in countries like India, understanding the role of obesity in fibroid development is critical for prevention and management…
By taking proactive steps like weight management, exercise, and timely medical intervention, women can reduce their risk of fibroids and manage the condition effectively.
Lydia, is a Specialist Dietitian at The London Obesity & Endocrine Clinic. She has helped many patients overcome weight management barriers. ©Simplyweight
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