How to lose weight with PCOS (polycystic ovarian syndrome)

If you have polycystic ovary syndrome (PCOS), figuring out how to lose weight often feels like an impossible task. The hormone imbalances and insulin resistance common with PCOS make it more challenging to maintain a healthy weight. 

Still, these tips can help support you on your journey to losing weight with PCOS. 

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PCOS is a hormonal health condition affecting women of reproductive age. Women with PCOS often have high levels of androgens. Androgens are usually thought of as male sex hormones, but they also exist in smaller amounts in women (Leon, 2021). 

Women with PCOS tend to experience irregular periods from the imbalanced hormones and may develop ovarian cysts. Symptoms of PCOS can include (Leon, 2021):

• Irregular periods (longer than 35 days between menstrual cycles)

• Painful and heavy menstrual periods

• Acne

• Excess body hair growth (hirsutism)

• Scalp hair loss or male pattern baldness

• Weight gain and obesity

• Insulin resistance

• Infertility

Typically, PCOS is treated with lifestyle changes, medications, or a combination of options. Some drugs used to treat PCOS include birth control, metformin, clomiphene, and spironolactone (Leon, 2021).

The hormonal imbalances, insulin resistance, and increased body weight are associated with some more severe complications, like type 2 diabetes, heart disease, and even endometrial cancer in some cases. But, rest assured, with the help of your healthcare provider, you can manage your PCOS symptoms and decrease your risks of these complications (Leon, 2021).

Multiple factors and symptoms of PCOS contribute to weight gain. Here are two common hormones that impact weight gain with PCOS:

Insulin 

Insulin resistance and high insulin levels affect up to two-thirds of women with PCOS (Leon, 2021). Insulin is the hormone responsible for bringing glucose (sugar) into cells from the blood. With insulin resistance, blood sugar levels may remain elevated, and your cells may not get the energy they need. 

Insulin resistance may make you feel hungry since the energy stays within your blood but doesn’t make it into the cells where it’s needed. Research shows there is a relationship between insulin resistance and weight gain (Verkouter, 2019). 

Androgens

Excess androgen in women often leads to weight gain. This hormone also makes it more likely for fat to be stored in the abdomen, which can further worsen insulin resistance and PCOS symptoms (Pasquli, 2019).

Research suggests that even a moderate weight loss of 5% can improve insulin resistance, androgen production, menstrual cycles, and fertility (Rondanelli, 2014). The following tips can help you reach a healthy weight with PCOS. 

1. Lower your carb intake

Almost all types of carbohydrates are broken down during digestion into glucose (sugar). So, any carbohydrates you eat require insulin to bring the glucose into your cells. Overeating simple carbs and sugary foods may worsen insulin resistance and increase your risk of developing type 2 diabetes. 

Instead, try to focus on a low-carb diet. Try to prioritize foods high in complex carbs (meaning they contain fiber) because complex carbs take longer to digest and absorb. Examples of complex carbs include:

• Leafy greens

• Whole grains

• Oats

• Legumes and lentils

2. Eat plenty of fiber

Fiber is a type of carb that your body can’t fully break down. Instead, it’s partially broken down and moves through the digestive system. Benefits of fiber include (Barber, 2020):

• Increased regularity with bowel movements

• May aid weight loss

• Increased insulin sensitivity

• Improved gut bacteria health

• Reduced chronic inflammation

Fiber supports digestion and weight loss because it takes longer to digest. It absorbs water and helps slow down food as it moves through your digestive system. This helps you stay full for longer and helps stabilize blood sugar levels (Barber, 2020). 

3. Eat protein with every meal

Protein helps you feel full longer after eating, stabilizes blood sugar, and supports healthy muscles and other body functions. Research suggests replacing some carb foods with protein helps support weight loss in individuals with PCOS (Sorensen, 2012). 

Try to pair any carb foods with protein to help maintain more stable blood sugar and support weight loss. Here are some examples you could try:

• Berries with greek yogurt

• Fruit with low-fat cottage cheese

• Chicken with brown rice

• Eggs with whole grain toast

4. Eat probiotics

Some early research suggests there is a relationship between an unhealthy gut microbiome and the development of PCOS (Yurtdas, 2020). The research in this area is still too early to fully understand how probiotics and gut health impact PCOS. Still, improving gut health may impact PCOS and healthy weight maintenance. 

Consider regularly consuming a probiotic supplement or fermented foods such as:

• Kefir

• Kimchi

• Yogurt

• Miso

• Sauerkraut 

5. Consume healthy fats

Healthy fats may help you feel more satisfied and full after your meals. This may help stabilize blood sugar levels and improve insulin resistance. Research suggests diets high in monounsaturated fats may help to support maintaining a healthy weight for people with PCOS (Moran, 2013). 

Examples of healthy dietary fats include:

• Olive oil

• Fatty fish (salmon, mackerel, tuna, etc.)

• Nuts

• Avocado

• Seeds

6. Practice mindful eating

Mindful eating involves focusing completely on your food while eating. Distracted and mindless eating tends to cause excessive calorie intake. Practicing mindfulness brings awareness to how hungry you feel and how much you need to eat. Research suggests a mindful eating practice supports healthy weight maintenance and weight loss (Dunn, 2018). 

7. Exercise regularly

Frequent exercise may help people with PCOS maintain a healthy weight in a few ways. It can  (Woodward, 2020):

• Increase the number of calories burned during the day

• Increase muscle mass and metabolism

• Help improve insulin sensitivity and insulin levels

• Boost mental health

The guidelines for exercise with PCOS recommend a minimum of 150 minutes or 2.5 hours of physical activity each week (Woodward, 2020). Not all physical activity needs to be an intense workout. Consider working more movement into your day by:

• Walking

• Dancing

• Taking the stairs

• Going for a bike ride

• Cutting grass with a push lawn mower

• Gardening

• Doing strength and cardio workouts

8. Manage your stress levels

Chronic stress impacts hormones, mental health, and weight. A 2018 research study found that adopting healthy lifestyle changes along with a stress management program leads to significantly more weight loss and BMI reduction than lifestyle changes alone (Xenaki, 2018). 

Ideas to help manage stress include:

• Mindfulness meditations

• Deep breathing exercises

• Walking

• Writing in a journal

• Talking with a friend

9. Get enough sleep

Research shows that a lack of sleep increases hunger and likely contributes to weight gain. People within the study lost more weight when they slept an average of 8.5 hours per night compared to 5.5 hours (Ogilvie, 2017). 

Try these tips to get a better night's rest:

• Try to maintain a consistent bedtime and wake-up time.

• Keep your room cool, dark, and quiet.

• Dim the lights as you start winding down for bed.

• Limit screen time before bed.

• Limit caffeine in the afternoon and evening.

The hormonal imbalance and metabolic changes people with PCOS experience do make it more challenging to lose weight. Still, it’s possible to maintain a healthy weight. These nine tips can help support weight loss with PCOS. If you have any questions or concerns, talk with your healthcare provider or a dietitian to help support your weight loss journey.