If you have PCOS, you’re likely aware that it can impact your weight. So how can you lose weight with PCOS and manage your other symptoms?
What is polycystic ovary syndrome (PCOS)?
Polycystic ovary syndrome, or PCOS, is a condition that impacts hormone levels in women. PCOS typically causes high levels of androgens, a type of male hormone.
Elevated androgen levels can lead to PCOS symptoms such as irregular menstrual cycles and/or bleeding lack of or irregular ovulation, cysts on your ovaries, enlarged ovaries, weight gain, oily skin, acne, unwanted hair growth (especially on your face), hair thinning, and infertility.
What are the symptoms of PCOS?
Some of the common PCOS symptoms include:
- High androgen levels – high levels of androgens such as testosterone and DHEAS can lead to symptoms like thinning hair, unwanted hair growth, acne, and oily skin.
- Insulin resistance – high insulin levels and/or high blood sugar can be identified through blood tests. Skin tags and darkened patches in your skin can also be a sign of insulin resistance.
- Irregular periods or very light periods
- Lack of ovulation
- Infertility – many women with PCOS, need fertility treatment to aid in conceiving
- Metabolic syndrome – excess weight gain in your belly, high blood sugar, high cholesterol, and high blood pressure are all aspects of metabolic syndrome
- Pelvic pain
Diagnosis of PCOS
PCOS is one of the most common causes of infertility and is estimated to impact 6-12% of women of childbearing age. It can impact you regardless of your weight, though the majority of women with PCOS are considered overweight or obese.
PCOS is diagnosed if you meet at least two of three categories: high androgen levels (testosterone levels), lack of or absent ovulation, and cysts on your ovaries.
PCOS can be diagnosed with an ultrasound of your ovaries in addition to blood tests. There is no definitive test for PCOS since it is a syndrome that is defined as a “set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.”
PCOS and insulin resistance
Insulin resistance is when your body doesn’t respond to insulin effectively or your body doesn’t make enough insulin. It is commonly associated with PCOS. Insulin is a hormone made by your pancreas that helps lower your blood sugar levels.
When you have insulin resistance, your body will produce more insulin to try to lower your blood sugar levels. High insulin levels drive high androgen levels, which worsen PCOS symptoms.
Insulin resistance can lead to weight gain, which is why many women with insulin-resistant PCOS are considered overweight or obese. Having insulin resistance also increases your risk of developing diabetes. Women considered of “normal” body weight may also have insulin resistance, though it isn’t as common.
If you have insulin-resistant PCOS, you’re at a higher risk of developing type 2 diabetes later in your life.
PCOS and weight
Weight gain can be a symptom of PCOS. The main reason you might gain weight with PCOS is because of underlying insulin resistance. Between 40 and 85% of people with PCOS are considered overweight or obese.
When you’re insulin resistant, your body will try to produce more insulin to help keep your blood sugar levels under control. Insulin is a fat-storage hormone, which means high insulin levels can cause weight gain.
It’s not always clear if PCOS causes weight gain or if it’s the other way around. Being overweight or obese can increase your risk of insulin resistance, which can then increase your risk of developing PCOS. Even if PCOS doesn’t cause your weight gain, it can make it more difficult to lose weight once you’re insulin resistant.
Being insulin resistant can cause carbohydrate and/or sugar cravings in some people. Carbohydrates and sugar raise your blood sugar levels, prompting your body to try to release enough insulin to lower your blood sugar. A frustrating cycle of carbohydrate and hunger cravings increased blood sugar levels, and increased insulin levels can make it harder to achieve weight loss.
Oral contraceptives are used to mask PCOS symptoms, but they don’t treat the root cause. Once you stop taking oral contraceptives, your PCOS symptoms will likely return. The longer you take birth control pills, the longer it can take for your body to try to regulate your hormones on its own.
How to lose weight with PCOS
There isn’t one magic fix to lose weight with PCOS. Your weight loss journey might include natural supplements, lifestyle changes, or blood sugar medications to improve your insulin sensitivity.
You should work with your healthcare provider to establish your health goals and determine which methods might be effective for you to lose weight with PCOS.
1) Reduce your carbohydrate intake
Carbohydrates (most often called carbs) are found in fruit, vegetables, grains, legumes, and dairy products like milk and yogurt. They’re also found in sugar-sweetened products like desserts and sugary drinks.
Carbohydrates aren’t bad, but they do have a big impact on your blood sugar level and insulin resistance. When you eat carbohydrates, they’re broken down into glucose in your bloodstream.
Not all carbohydrates are created equally. High-fiber carbs from fruits, vegetables, whole grains, legumes, and unsweetened dairy products are much better for you than refined carbs like sugar-sweetened foods and drinks and enriched grains like white bread and white rice.
Instead of looking to cut out carbs or go on a very low carbohydrate diet like a keto diet, try to improve the quality of the carbs in your diet and reduce portions of added sugar and refined carbs.
You should also look to include non-starchy vegetables. Not only are vegetables among the best foods to eat for PCOS, but they have many other health benefits. Non-starchy vegetables are very low in carbohydrates, which means they won’t raise your blood sugar or insulin levels significantly. If you have insulin-resistant PCOS, this is especially helpful.
Certain foods and drinks can worsen your PCOS symptoms. By identifying the ones that cause irritation, you may be able to effectively manage the condition to some extent. Foods you should avoid include:
2) Avoid certain Foods
- Sugary drinks: Regularly consuming sugary beverages can worsen insulin resistance and may contribute to inflammation. Consuming extra calories from added sugar can make it difficult to reach a healthy weight if you’re working towards weight loss.
- ‘Health’ Foods: Added sugar isn’t always easy to spot in foods. Sugar is added to foods that might otherwise seem healthy, like yogurt, dried fruit, some nutrition bars, and granola. Many processed foods contain added sugar.
- Omega-6 fatty acids: are pro-inflammatory, while omega-3 fatty acids have anti-inflammatory properties. Some sources of omega-6 fatty acids and foods to avoid with PCOS include corn oil, vegetable oil, soybean oil, sunflower, and safflower oils. Meat from animals fed a grain-based diet is also higher in omega-6 than omega-3s. Instead, try to include healthy fat from foods like fatty fish, nuts, seeds, and grass-fed meat.
3) Get plenty of magnesium
If you have PCOS, you’re more likely to be deficient in magnesium. Magnesium not only helps promote relaxation to help manage stress levels, but it might also play a role in insulin resistance and weight management. Women with polycystic ovary syndrome are more likely to be deficient in magnesium. Magnesium not only helps promote relaxation to help manage stress levels, but it might also play a role in insulin resistance.
Some magnesium-rich foods to eat with PCOS include:
- Pumpkin seeds
- Peanuts, peanut butter, and other types of nut butter
- Black beans
- Dark chocolate with 60-69% cocoa
4) Move your body
Being physically active provides numerous health benefits, including mental health benefits. Getting enough exercise can help you manage your weight, improve insulin sensitivity, and reduce PCOS symptoms.
Aim to get 30 minutes of moderate-intensity exercise most days of the week. Pick something you enjoy, whether it’s walking, doing group exercise classes, stair master, swimming, or working in your garden.
5) Consider blood sugar medications
If your healthcare provider thinks you might benefit from a blood sugar medication, it might help with your weight loss journey.
Many healthcare providers prescribe metformin to help manage PCOS symptoms. Metformin helps treat insulin resistance, the common root of PCOS. Metformin helps sensitize cells to insulin, making losing weight with insulin-resistant PCOS easier. It may also help improve hormonal imbalances and regulate irregular menstrual cycles.
Metformin treatment has been shown to inhibit androgen production, which can help lessen some unwanted side effects of PCOS like unwanted hair growth. Lowering testosterone levels (the primary type of androgen) may help you achieve better hormonal balance.
A study found that obese women lost weight due to metformin treatment. However, metformin isn’t meant to be used as a weight-loss drug.
Ozempic is another blood sugar medication that can help you lose weight with PCOS. Like metformin, Ozempic isn’t meant to treat PCOS but may be used off-label to do so. Since Ozempic can improve insulin sensitivity and promote weight loss, it may improve symptoms of PCOS.
When discussing weight loss medications, it’s worth talking about wegovy vs ozempic. Wegovy is another option to consider, which was approved for weight management in 2021. It is a different brand name of the same medication as Ozempic (semaglutide).
6) Consider natural supplements
Certain supplements might improve your PCOS symptoms and help you lose weight. One of the most well-known supplements for PCOS is inositol.
Myo-inositol and D-chiro inositol are vitamin-like substances with insulin mimetic properties, which means they act similar to insulin. Myo- and D-chiro inositol have been studied for their ability to improve insulin sensitivity and are often recommended for women suffering from PCOS to reduce symptoms.
Inositol has been studied in direct comparison with metformin in insulin resistant women. Both metformin and myo-inositol were found to have similar positive effects on insulin levels, fasting blood sugar, and hormone levels associated with PCOS. Improvements in insulin sensitivity and blood sugar levels can make weight loss less difficult.
Can weight loss improve PCOS symptoms?
Losing weight helps improve insulin sensitivity, which can help you lose weight. Even if you don’t have insulin-resistant PCOS but are overweight or obese, losing weight might still help you manage your PCOS symptoms.
Weight loss helps your cells become more sensitive to insulin. When you’re more sensitive to insulin, your body produces less of it, which can help you lose weight.
Losing 10% of your body weight might be enough to help regulate irregular periods and reduce PCOS symptoms. For a 200-pound person, that would be 20 pounds.
When it comes to weight loss, the key is to make sustainable changes that you can stick with long-term. Otherwise, you might have a hard time maintaining the weight loss.
The most effective way to lose weight with PCOS is to treat any underlying insulin resistance. Other ways to lose weight with PCOS include being physically active, eating high-fiber foods, decreasing your added sugar intake, and taking supplements that help improve your insulin sensitivity.