How to Lose Weight with PCOS: Tips| US News
Weight gain isn’t all that uncommon. Neither is having trouble losing weight. However, for women with polycystic ovarian syndrome, or PCOS, trying to lose weight can feel like a never-ending battle.
And not just for cosmetic reasons. Many women report that their symptoms get worse when they’re above their normal weight.
What Is PCOS?
Despite its name, PCOS doesn’t just affect the ovaries. The exact cause of this metabolic and hormonal disorder is unclear. However, it’s probably a combination of certain genetic and environmental factors. Women with PCOS usually start showing symptoms as they enter puberty.
PCOS is a spectrum disorder, meaning that its symptoms occur on a continuum and may appear more intensely in some people than others. The underlying cause of PCOS is an imbalance of hormones but what causes this imbalance isn’t clear.
“PCOS is a complex endocrine disorder that affects at least one in ten women of childbearing age,” says Angela Grassi, a registered dietician and founder of the Malvern, Pennsylvania-based PCOS Nutrition Center and co-author of “The PCOS Workbook: Your Guide to Complete Physical and Emotional Health.”
Symptoms of PCOS
Symptoms of PCOS include:
When making a diagnosis of PCOS, your doctor typically looks for you to meet at least two of these three criteria:
- Irregular menstrual periods. This means you are not getting your period on a regular cycle every month.
- Cysts on your ovaries, which are visible on a pelvic ultrasound. These are solid or fluid-filled pockets on your ovaries.
- High levels of the hormone androgen in your blood.
PCOS and Insulin Resistance
Being significantly overweight and carrying that weight around the belly region is the number one risk factor for insulin resistance, along with a lack of physical exercise. Insulin resistance occurs when your body doesn’t recognize and respond to insulin as it should. According to a 2011 study published in the World Journal of Diabetes, up to 70% of women with PCOS also have insulin resistance.
“Simply put: When we eat foods – mostly carbohydrates – they get converted into glucose in our bloodstream,” Grassi explains. “We need the glucose to enter our cells to be used for energy. When blood glucose levels rise, a signal – imagine a doorbell is rung – is sent from the cell door to the nucleus telling it to open up. However, with PCOS, the doorbell on the cell door may be defective. This means that it takes longer for the cells to open its doors to glucose resulting in higher amounts of insulin needing to be secreted.”
When this happens to a person over time, glucose levels can remain too high for too long, resulting in those “cell doors” eventually ignoring the insulin. This can then cause Type 2 diabetes to develop.
Like many aspects of the disorder, PCOS and its relationship with insulin requiring more research to be fully understood resistance, Hillary Wright explains, a registered dietitian and the director of nutrition counseling for the Domar Center for Mind-Body Health in Waltham, Massachusetts. “This thing we call PCOS, we’ve known about for over 100 years, but it’s only been since the 1990s that we’ve come to realize a very important player going on behind the scenes is insulin resistance.”
While it’s unclear with weight gain or insulin resistance first comes in a person with PCOS, studies, like the one published in Nutrients in 2017, have shown that maintaining a healthy weight can reduce unwanted PCOS symptoms.
What Triggers Weight Gain in People With PCOS?
The hormonal imbalance that PCOS triggers cause some women to report having intense food cravings, due to the overproduction of insulin, and never feeling full or satiated, due to the underproduction of hormones like ghrelin, cholecystokinin and leptin, which regulate hunger.
Just as important as the weight itself, is where the weight is stored on the body. With insulin resistance, the body often stores fat in the abdominal region – which puts a person at higher risk for heart disease and Type 2 diabetes.
The vicious cycle with PCOS is that “insulin resistance encourages (the) storage of fat in the belly fat, which in turn aggravates insulin resistance,” Wright says. This creates a chain reaction of gaining weight, which worsens insulin, which goes on to further increasing resistance the symptoms of PCOS.
This chain reaction between insulin resistance, belly fat and weight gain with PCOS makes weight easier to gain – and harder to lose it.
High stress, poor sleep and a sedentary lifestyle can all lead to weight gain, particularly in women with PCOS.
“In women with PCOS, these lifestyle factors become compounded and can make weight gain happen even more quickly,” says Maude Morin, a registered dietitian at JM Nutrition, in Ontario and New Brunswick, Canada, a firm that specializes in nutritional interventions for women’s health concerns.
Losing Weight With PCOS
“There is no one way to manage PCOS, just like there’s no one way to lose weight,” Wright says. However, in “women with PCOS who have obesity, if they lose as little as 5% to 10% of their weight that will improve their insulin resistance, which can only be beneficial for their fertility and their overall health.”
Many dietitians find success in controlling PCOS symptoms with a plant-based diet. This may include eating more whole grains, fruits and vegetables, seafood or plant-based proteins like legumes and nuts, and eating little red meat, refined carbohydrates and processed foods.
“Basically, women with PCOS have a greater incentive to eat the way all of us should be eating,” Wright says.
If you’re looking to lose weight, you should find a dietitian or endocrinologist who has a history of working with people who have PCOS and understand the intricacies of the disorder. They can provide care tailored to your needs and can fact-check info you’ve found online.
“It is helpful to be a savvy consumer of social media accounts and medical recommendations that are prolific on social media platforms, as they may offer very little science or research-based recommendations,” says Audrey Castell Watts, a private practice dietitian based in Connecticut . “Unfortunately, because PCOS is under-researched, there is a limited overall understanding of the condition, and because those who suffer with PCOS are often desperate for answers and solutions, unethical individuals can take advantage of a population that really needs and deserves informed and comprehensive medical care.”
Some doctors, like Grassi, advocate for an emphasis on a change in behavioral patterns over weight loss.
“The most common advice given to people with PCOS from doctors is to lose weight. Chances are, people with PCOS have tried to lose weight, many times. In fact, eating disorders and mood disorders are highly prevalent in the PCOS population partly due to the (unsuccessful) efforts at losing weight,” Grassi says. However, she stresses that people with PCOS “can improve their health without having to lose weight.”
Lifestyle changes like eating meals balanced in protein, carbs and fats, regular physical activity, stress management and proper sleep may not necessarily lead to weight loss, but they will definitely be effective in regulating insulin and balancing hormones.
“The main thing for someone with PCOS to remember when trying to lose weight is that managing the symptoms should be the first priority,” Watts says. “Get your hormones checked and see where you need to spend your energy making changes.”