PCOS. Is this the bane of your weight loss journey?

We speak to a lot of women who struggle with PCOS, and they often feel:

😫 Hopeless by not being able to lose weight–no matter what they do

😫 Discouraged about the way they feel in their body

😫 Not in control over their body

It can be frustrating to attempt weight loss with PCOS–Especially since there are so many mixed messages about this condition. (Do you need to do gluten free? Keto? Fasting?) 

The good news: It is completely possible to lose weight and manage PCOS symptoms, if you have the right approach.  

In The BBR coaching programs we’ve worked with many women with PCOS to successfully lose weight and keep it off for good.

In this article, we’re going to everything you need to know about weight loss with PCOS. 

First, let’s understand a little bit more about PCOS and how it affects weight:

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormone disorder in women, affecting around 10% of women. The hormonal imbalances create problems with your menstrual cycle: Your egg may not develop as it should during the menstrual cycle each month, or it may not be released during ovulation as it should be. 

Women with PCOS have higher levels of androgens (male hormones that females also have), which can cause symptoms like irregular periods, acne, thinning scalp hair, excess hair growth on the face and body, and weight gain in the midsection area.

No one is 100% sure of what causes PCOS. It could be a wide variety of factors, including genetics, lifestyle habits, and environmental space.

Women with PCOS have a greater likelihood of developing diabetes, cardiovascular disease, and endometrial cancer than women without the condition. 

There is no cure for PCOS, but with the right approach, you CAN balance your hormone levels, regulate your period, and manage your PCOS symptoms such as acne, hair growth, and more. Some people call this “reversing” PCOS.  

Losing weight and living a healthier lifestyle plays a big part in managing PCOS symptoms: Research shows that losing as little as 5% of your body weight can reduce hyperandrogenism and improve menstrual regularity¹.

Some women with PCOS opt to take medication like birth control that might treat symptoms such as irregular periods, acne, excess hair, and elevated blood sugar. Fertility treatments are also available to help women with PCOS get pregnant. 

Unfortunately PCOS can seem like a Catch 22: Weight gain alleviates symptoms, but the very nature of the condition makes weight management challenging. 

How Does PCOS Affect Your Weight?

There are a few main ways that PCOS can lead to weight gain:

1. Insulin Resistance

As many as 80% of women with PCOS have what’s called insulin resistance. Insulin is a crucial hormone that helps your body take glucose from your bloodstream and turn it into fuel for the body. 

Think of insulin like a “key:” After you eat, your body breaks down carbs into sugars (glucose). Your body releases insulin into the bloodstream after eating, and the insulin is like a “key” that opens the door to the cell to use that glucose for energy. 

But if those keys aren’t working property, what happens? Instead of going into your cells, this sugar builds up in your bloodstream and creates high blood sugar levels.

Your body then produces extra insulin in an attempt to process the glucose… But since not much of that glucose is actually going into your cells properly, your body thinks it’s not getting any food.  

This causes you to feel hungrier, get intense carb cravings, and then eat more to satisfy your cravings.

And guess what happens to all those excess calories and blood sugar floating around in your bloodstream? 

Yup, they get stored as body fat. 

High levels of insulin also increase the production of androgens. And, surprise, high androgens can also lead to weight gain–particularly in the midsection.

2. Your metabolism may be lower

Early research indicates that women with PCOS may have a slightly reduced metabolism compared to those without PCOS.

One study evaluated 91 women with PCOS, and found that women without PCOS had a basal metabolic rate (BMR) of 1,868 calories. In comparison, women with PCOS and no insulin resistance had a BMR of 1,590 calories. The group with PCOS plus insulin resistance had a BMR of 1,116 calories.²

Note that this was just one study, and there hasn’t been much more research in this topic. But if PCOS affects BMR this much, this could be a HUGE difference in daily energy needs! This lowered metabolism can explain why even though you’re eating “healthy,” you might not be in a calorie deficit and losing weight.

If you have PCOS, there’s change you may require a slightly lower calorie deficit than someone without PCOS to lose weight. 

3. Mental health struggles may affect physical health

Something that’s often overlooked is that women with PCOS are three times more likely to also suffer from anxiety and depression.³

On top of this, studies have shown that women with PCOS have greater body dissatisfaction than those who don’t.³ 

Mental health, internalized body shame, and body image struggles may lead to living a less active lifestyle or participating in emotional eating, which can affect your weight. 

4. Inflammation

PCOS is associated with inflammation throughout your body.⁴ Inflammation can cause symptoms like fatigue or pain, and can put added stress on the body. Chronically high inflammation can is associated with high cortisol levels, which is associated with weight gain and depression.

5. Stress makes everything worse

Cortisol is the hormone our bodies release under stress. High cortisol can drive insulin resistance even higher, drive up androgens, and further exacerbate PCOS symptoms, make it even more difficult to lose weight.⁵

How to Lose Weight With PCOS?

Here are five things to focus on to lose weight with PCOS:

1. Eat in a moderate calorie deficit 

All weight loss starts with eating in a calorie deficit: This means you are eating fewer calories than you burn through daily movement and activity.

If you want a refresher on what a calorie deficit means and how to achieve it, watch my video Fat Loss Fundamentals to understand a little more about how your calorie needs.

Due to a possible lower BMR, you may require a slightly larger calorie deficit than a person without PCOS. (Or an increased level of activity via daily steps, exercise, etc).

Please note: This does not mean to drastically under-eat or spend hours on the treadmill.

You have to find the sweet spot that works for your body to lose weight in a healthy and sustainable way. If you cut too low, you’ll get too hungry and be unable to adhere to your deficit. Remember that everyone’s body and needs are different and there is NO one size fits all approach. 

Consider tracking your calorie intake for a few weeks to get a sense of how much you’re eating now, then reduce from there. Start with a 10-20% deficit from your maintenance levels. Prioritize protein, vegetables, and healthy fat sources. An overall calorie deficit in general will help improve insulin sensitivity, as well.

If you want 1:1 support to lose weight with PCOS you can click here to work with The BBR team. 

2. Try a lower-carb diet

I’m not suggesting you start a zero carb or keto diet. This isn’t a realistic or sustainable diet for many people–Especially for those of you who are vegetarian, in which case many of your protein sources come with carbs attached. 

But if you struggle with insulin resistance related to PCOS, reducing your carb intake can help you reduce cravings, increase your energy, and achieve the weight loss results you want.

Start by getting a baseline of your current carb intake, and reducing it slowly from there.  Pay attention to how you feel at different carb levels: How’s your energy? How’s your appetite? How are your cravings? Everyone tolerates carbs a little differently, so find the sweet spot that works for you.

Stick to slower, whole grain carbs instead of processed chips, cookies, and candy. Complex carbs will digest more slowly and cause less of a high insulin response.

For example: 

• Instead of two slices of toast in the morning, try one slice of whole grain toast and an egg for some protein 
• Swap regular pasta for lentil pasta, which is higher protein and fiber
• Try swapping rice for quinoa or cauliflower rice

Remember: The more extreme your dietary changes are, the less likely you will be to stick to them. Scale back on carbs slightly from where you’re at now and decrease from there. You have to balance optimal with what is sustainable and realistic for you to stick to long-term.  

3. Lift weights

Research shows that strength training can actually help improve insulin resistance. Building muscle will also help improve your Basal Metabolic Rate and help you burn more calories at rest.  

Click here for our Free Dumbbell Workout Guide to get started with weights! 

4. Manage Stress

Stress exacerbates PCOS symptoms by driving up androgens and cortisol. On top of this, it can cause you to emotionally binge or stress eat. 

Learning how to de-stress in healthy manners will help heal your body inside and out and is key for PCOS management.

If you struggle with emotional eating during stressful times, download our free End Emotional Eating toolkit which contains several resources to de-stress and cope with overwhelming emotions. 

5. Focus on Sustainable Habits Over Quick Fixes

Adopt behaviors you can sustain and stick to long-term. A lot of women I see attempt extreme diets in an attempt to manage PCOS… Only to fail and re-gain the weight when they can’t stick to things any more. 

At The Boss Body Revolution, our goal is to help you lose weight in a healthy and sustainable way that you can actually stick to for the rest of our life. 

Final Words:

While this article contains general advice around weight loss with PCOS, remember that there is NO one-size-fits-all approach to losing weight–especially when you have PCOS. Every single body is different.

We work with some women whose bodies handle carbs just fine, while other women respond better to a lower carb diet. Some women with PCOS have a high metabolism and don’t need much of a calorie deficit, while other women may require a larger deficit. I know I sound like a broken record here–But the key is to eat in a way that’s effective for your body, while being sustainable for you long-term.

Want 1:1 Support to Lose Weight with PCOS? 

We help many women with PCOS successfully lose weight and keep it off for good. In our coaching program, The Boss Body Revolution, we develop a plan tailored for your body and lifestyle, and give you all the support you need to stay consistent. If you’re ready to feel great in your body, click here.

What to Read Next:

PCOS Nutrition FAQs: Gluten, dairy, soy, and more

SOURCES:

1. Rondanelli M, Perna S, Faliva M, Monteferrario F, Repaci E, Allieri F. Focus on metabolic and nutritional correlates of polycystic ovary syndrome and update on nutritional management of these critical phenomena. Arch Gynecol Obstet. 2014 Dec;290(6):1079-92. doi: 10.1007/s00404-014-3433-z. Epub 2014 Sep 9. PMID: 25200687.

2. Georgopoulos NA, Saltamavros AD, Vervita V, Karkoulias K, Adonakis G, Decavalas G, Kourounis G, Markou KB, Kyriazopoulou V. Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance. Fertil Steril. 2009 Jul;92(1):250-5. doi: 10.1016/j.fertnstert.2008.04.067. Epub 2008 Aug 3. PMID: 18678372.

3. Dokras A, Stener-Victorin E, Yildiz BO, Li R, Ottey S, Shah D, Epperson N, Teede H. Androgen Excess- Polycystic Ovary Syndrome Society: position statement on depression, anxiety, quality of life, and eating disorders in polycystic ovary syndrome. Fertil Steril. 2018 May;109(5):888-899. doi: 10.1016/j.fertnstert.2018.01.038. PMID: 29778388.

4. González, Frank. “Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction.” Steroids vol. 77,4 (2012): 300-5. doi:10.1016/j.steroids.2011.12.003

5. Basu, Barnali Ray et al. “Possible Link Between Stress-related Factors and Altered Body Composition in Women with Polycystic Ovarian Syndrome.” Journal of human reproductive sciences vol. 11,1 (2018): 10-18. doi:10.4103/jhrs.JHRS_78_17

6. Zhang X, Zheng Y, Guo Y, Lai Z. The Effect of Low Carbohydrate Diet on Polycystic Ovary Syndrome: A Meta-Analysis of Randomized Controlled Trials. Int J Endocrinol. 2019 Nov 26;2019:4386401. doi: 10.1155/2019/4386401. PMID: 31885557; PMCID: PMC6899277.

7. Di Meo S, Iossa S, Venditti P. Improvement of obesity-linked skeletal muscle insulin resistance by strength and endurance training. J Endocrinol. 2017 Sep;234(3):R159-R181. doi: 10.1530/JOE-17-0186. PMID: 28778962.