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Losing weight can be harder if you have PCOS. Here are 4 tips to make it easier, according to experts.

Rachel Hosie   

Losing weight can be harder if you have PCOS. Here are 4 tips to make it easier, according to experts.
  • PCOS can make it hard to lose weight because of insulin resistance and inflammation.
  • Losing weight can help reduce the symptoms of PCOS in people who are overweight.

Polycystic ovary syndrome is the most common hormonal disorder in women of reproductive age, and can affect both ovulation and the hormones that play a role in metabolism.

People with PCOS often have cysts on their ovaries and produce higher than normal levels of testosterone. Symptoms include facial hair, irregular periods, acne, and difficulty losing weight.

Not all people who have PCOS are overweight or obese, but losing weight can help reduce symptoms in those who are, Dr Channa Jayasena, a consultant in reproductive endocrinology and andrology at Imperial College and Hammersmith Hospital, UK, told Insider.

It's unclear why weight loss helps, but Dr Stephen Franks, professor of reproductive endocrinology at Imperial College London, told Insider there's evidence it helps to balance hormone levels and improve ovulation.

For those who want to lose some fat, Insider spoke to three experts for some advice.

Why losing weight can be harder if you have PCOS

The two main reasons people with PCOS may struggle with their weight are insulin resistance and inflammation, Jodie Relf, a dietitian who specializes in PCOS, told Insider.

Low grade chronic inflammation can leave some people feeling exhausted, making it harder to exercise or prepare healthy meals, she said.

Insulin resistance is when cells are not as responsive as they should be to insulin, the hormone that controls blood sugar levels. This can make the brain think you haven't eaten enough food, causing hunger even after eating.

An excess of insulin caused by insulin resistance leads the body to store fat, particularly around the abdomen, Relf said.

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While weight loss can help, the common weight loss advice of "eat less and move more" is not generally helpful for people with PCOS, according to dietitian and PCOS weight loss specialist Tallene Hacatoryan.

"Restrictive eating and over-exercising actually creates a blood sugar roller coaster, which is counter-productive when trying to manage insulin resistance," she said.

4 tips for losing weight if you have PCOS

1. Balance your blood sugar with complex carbs

Complex carbs release energy slowly and are fiber-rich. They include wholegrain breads, pastas, and cereals, potatoes with the skin on, and bulgur wheat. Simple or "quick" carbs — such as white bread, pasta, or rice — release energy quickly in comparison.

When we eat sugary foods or "quick" carbs, our body produces more insulin, registered nutritionist and PCOS specialist Clare Goodwin told Insider. This can contribute to weight gain.

"When we eat 'slow' carbs with lots of protein and good fats, this helps to balance our blood sugar and reduce our insulin," she said. This can reduce cravings and overeating which can lead to weight gain.

Relf recommends eating lots of fruit and vegetables as well as complex carbs.

2. Prioritize protein and healthy fats

Eating protein with most meals helps slow the release of glucose, which keeps insulin down, Relf said.

"This doesn't mean you need to eat a high protein diet, simply aim to have protein with most meals," she said. Good protein sources include meat, fish, eggs, Greek yogurt, tofu, and beans.

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Healthy fats such as oily fish, seeds, nuts, and avocado are also good choices as they help to reduce inflammation, Relf said.

Eliminating gluten and dairy is sometimes recommended for people with PCOS because they can be inflammatory, but Relf said there is not enough scientific evidence to back this up.

Goodwin recommends having a breakfast smoothie made from almond milk, berries, protein powder, nut butter, and chia seeds, which includes health fats and protein.

3. Exercise to build muscle

Rather than doing high intensity workouts, which are cardio-based, focus on resistance training to build muscle.

"Muscle sucks up blood glucose, so your body doesn't have to produce as much insulin," Goodwin said.

Hacatoryan said: "Running for hours on the treadmill or doing back-to-back cycling classes is just going to pump more stress hormones, which leads to weight gain in the mid-section."

Keeping stress down is important as having raised levels of the stress hormone cortisol over a long period of time increases insulin, Relf said.

4. Sleep more

Sleep deprivation increases insulin production and cravings for sugary foods, Goodwin said. These can both lead to weight gain. She cited a small study that suggests sleeping for five hours a night for a week reduces insulin sensitivity by around a quarter.

Goodwin recommends aiming for between eight to nine hours of sleep a night.

Be kind to yourself and focus on healthy lifestyle changes

Managing PCOS requires treating yourself with kindness, the experts said.

People with PCOS should focus on healthy lifestyle changes that will help manage insulin resistance and inflammation, Relf said.

"Once these are managed, quality of life improves drastically as they have more energy, feel more confident within themselves, have better control of their symptoms, and they have a better relationship with food and their bodies," she said. "They may also lose weight, but this is not a focus or the goal."

Goodwin encourages people to throw away their scales and remember that weight gain is not always their fault.

"It's a symptom of this really complex hormonal process going on inside your body," she said, and "it may take longer to lose weight than someone without PCOS, which can be frustrating."

"PCOS is a challenge but also an opportunity to transform your mind and body early on, in ways that will help prevent future problems," Hacatoryan said. "You can truly thrive with PCOS."


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