Peter Weiss, MD, is a practicing OB/GYN and former Assistant Clinical Professor at the UCLA School of Medicine.
Polycystic ovary syndrome (PCOS) occurs when the ovaries make more androgen (a male sex hormone) than needed. Symptoms include lack of ovulation, irregular menstruation, acne, and excess body hair.
PCOS is linked to insulin resistance and obesity. Up to 60% of people with the condition are overweight or obese. PCOS increases the risk of weight gain and obesity, and obesity can cause and worsen PCOS symptoms
PCOS treatment options depend on the symptoms. Initial treatment options often involve losing weight if that's a goal. Weight loss can help improve ovulation, insulin resistance, and testosterone levels.
Consuming more fiber can increase the probability of losing weight. Fiber can help you reduce calorie intake by suppressing appetite and slowing digestion. This keeps you fuller for longer and reduces the rate at which glucose (sugar) is released into the bloodstream.
High-fiber foods include:
Making exercise a part of your daily routine benefits your physical and mental health. Exercise can help you lose weight by stimulating muscles to use excess glucose in the blood and promoting ketosis (burning stored fat for energy). PCOS guidelines recommend at least 150 minutes of physical activity per week.
Exercise can improve other PCOS symptoms. For example, it can help:
Reducing or limiting your intake of carbohydrates is advisable if you have PCOS, as you are at a higher risk of developing insulin resistance (when your body does not use insulin effectively).
Carbohydrates can worsen insulin resistance, promote inflammation, and lead to weight gain, worsening PCOS symptoms. This is especially true for refined carbohydrates or those with a high glycemic index (GI), such as sweeteners, juices, white bread/pasta/rice, and processed cereals.
Carbohydrates are the body's preferred energy source, so you don't need to eliminate them from your diet. Being mindful of your intake can promote weight loss by reducing calorie intake and the risk of a blood sugar spike.
Try the following strategies:
People with PCOS are at a higher risk of sleep conditions like insomnia and sleep apnea. These conditions often worsen with obesity. Sleep can also promote or hinder your effort to lose weight.
Lack of quality sleep can affect your appetite and how your body processes food. It can slow metabolism, causing the body to burn fewer calories. Reduced energy expenditure can lead to fat accumulation and weight gain over time.
Sleep significantly affects the hormones that control appetite and satiety. Lack of quality sleep can increase the level of ghrelin, known as the "hunger hormone," increasing hunger and food intake. Poor sleep also lowers leptin levels, a hormone that signals satiety (feeling full), resulting in increased food cravings.
These tips can help you get better sleep at night:
Stress can drain you physically, mentally, and emotionally. It can also cause weight gain or make it difficult to lose weight (e.g., cause you to eat more and slow your metabolism).
Stress causes the body to release adrenaline and cortisol, hormones that send the body into fight-or-flight mode. Constant stress and the continuous release of these hormones can set off chain reactions that cause weight gain.
The body releases cortisol during stress, which further triggers the release of adrenaline and noradrenaline. These hormones temporarily increase the body's "survival" functions and slow unnecessary functions. For example, they increase blood pressure and insulin production while suppressing digestion and metabolism. Cortisol can also trigger stress eating.
Here are some steps you can take to lower your stress levels:
Healthy gut bacteria may help boost metabolism and promote weight loss. Probiotics, often known as good or friendly bacteria, are live microorganisms naturally found or added to fermented foods like yogurt. You can also find them in supplement form.
Probiotics are believed to help replenish the gut's good bacteria. Studies have shown they have many health benefits, including improved metabolism and heart and digestive health.
People with PCOS may have fewer healthy gut bacteria compared to others, suggesting they may benefit from probiotics. One study published suggests that some probiotics may help with weight loss.
Protein may help people with PCOS lose weight. Protein can boost metabolism, build body mass, and promote weight loss. It can keep you fuller for longer, preventing unnecessary snacking or eating.
High-protein foods include poultry, fish, eggs, tofu, seafood, and beans.
Fats are more dense in calories than carbohydrates, but they are essential nutrients. Not all fats are the same; some are considered healthier options.
Healthy fats can promote feelings of fullness. Research has shown that they possess anti-inflammatory properties. They can also improve insulin resistance, boost your metabolism, and stimulate fat-burning, which can help with weight loss.
Water offers many benefits. It helps regulate body temperature and lubricate joints. Water can help you feel less hungry and prevent overeating. It supports metabolism, promotes digestion and fat burning, and doesn't contain calories.
Opt for water over sugary drinks, which are high in calories and packed with sugar with little or no nutrients.
Mindful eating, also known as intuitive eating, can be valuable if you need to manage your weight or obesity caused by PCOS. Consider paying more attention to what, when, and how much you eat.
With a food diary, you can track your eating schedule, whether you're making nutritious food choices, and the total calories you consume daily. A food diary may help you detect unhealthy patterns.
Losing weight with PCOS is possible, but it can be challenging due to factors like insulin resistance, hormonal imbalance, metabolic dysfunction, and sleep disorders.
If you are trying to lose weight but finding it difficult, consider sharing your concerns with your healthcare provider. Other providers, like a registered dietitian (RD) and a certified exercise specialist, can also help you achieve your goals.
Polycystic ovarian syndrome is a complicated condition, with some people being unaware that they have it. See your healthcare provider if you experience the following:
Obesity can worsen some of the symptoms of PCOS and lead to the development of metabolic conditions like diabetes and high blood pressure.
Losing and maintaining a weight that's healthy for you may be challenging for people with PCOS due to factors like hormonal imbalances and insulin resistance caused by the condition. Strategies like regular physical activity, dietary changes, quality sleep, and stress reduction may help.
Consider seeking the support of a healthcare team to lose weight and manage your PCOS symptoms.