PCOS Weight Loss Essentials: 5 Tips from a Dietitian

One of the biggest concerns I hear from my clients about their PCOS is how difficult it is to lose weight. After all, this is something I’ve struggled with myself too!

There are many reasons why it might be hard to lose weight with PCOS. If you are wondering what you can do to combat this, you are in the right place. 

In this post, I will walk you through why it’s difficult to lose weight when you have PCOS and 5 proven strategies to help you lose weight for good. 

What is PCOS?

To begin with, PCOS stands for polycystic ovary syndrome, a condition impacting the endocrine system, which regulates hormones (1). 

It occurs when the ovaries produce excessive amounts of certain hormones known as androgens, leading to symptoms like excess hair growth, acne, irregular periods, and infertility (1).

What Triggers PCOS?

While the precise cause remains unclear, several contributing factors have been identified. Three primary factors increase the risk and exacerbate symptoms:

1. Excessive androgen production by the ovaries (1), whose exact cause remains unknown.

2. Elevated insulin levels or insulin resistance, which may underlie PCOS (1). Insulin resistance occurs when the body improperly processes insulin, leading to its accumulation in the bloodstream. This can contribute to weight gain, increased androgen production, and exacerbated symptoms.

3. Persistent low-grade inflammation is associated with PCOS (1).

It’s important to note that these factors don’t necessarily cause PCOS. Researchers are still exploring whether they result from PCOS or contribute to its onset.

Addressing these factors through dietary and lifestyle changes can significantly alleviate PCOS symptoms and potentially induce remission.

How do these factors affect weight loss?

Insulin Resistance

First of all, insulin resistance may have an effect on weight gain and ability to lose weight in people with PCOS (2). Insulin is a hormone secreted by the pancreas that aids in the storage and utilization of blood sugar. 

Since insulin is a hormone that helps the body to store sugar, it is theorized that this is partly a reason why insulin resistance contributes to weight gain. 

Another reason why insulin may play a role is because when there are high amounts of insulin in the bloodstream, this may cause blood sugar to go too low. This is usually characterized as reactive hypoglycemia in people with PCOS. 

This hypoglycemia or high levels of insulin can cause cravings for high carbohydrate and often sweet foods even if you are not hungry. This is because the body needs this sugar to increase blood sugar levels once they have dropped. This can lead to a surplus of calories eaten. 

Leptin Resistance

The second reason that PCOS may affect weight is due to leptin resistance. Leptin is a hormone secreted by the body that tells your brain that you are well fed and are not hungry. This decreases the intake of food. 

In PCOS, research has shown that in people with high fasting insulin levels, leptin is also high (3,4). This could be due to leptin resistance. This means that although the levels are high, your brain might not be getting the message that you have eaten enough. 

This can lead to overeating and excessive hunger. I hear from many of my clients that they feel like they are never satisfied after meals and always hungry. This could be due to leptin. 

You may now be asking yourself, ok so then how do I possibly lose weight with PCOS? Well, in the next section I will walk you through 5 strategies to help you lose weight. 

How to Lose Weight with PCOS

1. Improve Insulin Resistance

There are many ways to improve and help resolve insulin resistance including eating balanced meals, supplements, exercise, and stress reduction. 

  • Eat balanced meals.
    • Include protein, fat, and fiber with every meal and snack. This helps to stabilize blood sugar and improve satiety. Check out my article here on how to make the perfect meal plan for PCOS. 
    • Aim for 30 grams of fiber daily. Fiber is so important for your hormones and blood sugar balance. Not to mention, it works wonders for your gut microbiome. 
  • Find a good supplement routine.
    • Supplements can be very helpful in improving insulin resistance. The best ones for this are inositol, fish oil, NAC, and berberine. 
    • Be sure to discuss this with your healthcare provider before starting new supplements. 

2. Decrease stress

Stress may play a role in weight gain in PCOS as an increase in stress has been associated with higher levels of weight gain (5). 

Stress can also affect the types of food we eat and how much. This is especially true if you struggle with emotional eating. 

So how do you reduce stress?

  • Sleep
    • Getting adequate sleep (7-9 hours) is crucial in how your body handles stress. When we do not get enough sleep, cortisol levels in the body can increase. 
    • Try to keep a consistent schedule, our bodies love routines!
    • Keep your room dark and cool. 
    • Establish a relaxing bedtime routine. 
  • Supplements
    • Ashwagandha may help to improve cortisol levels and reduce stress in the short term. 
    • Magnesium can help to manage stress and anxiety and may even improve your sleep. 
  • Learn how to cope with stress better.
    • There are many strategies for this, but the best one is to see a licensed mental healthcare practitioner. They are equipped with the knowledge and skills to help you best manage your stress. 
    • Other techniques include regular exercise, journaling, and prioritizing down time. 

3. Exercise

Even small amounts of exercise can help with weight loss and improve insulin resistance. Remember that 10 minutes of activity, 6 days a week is an hour of exercise you wouldn’t have gotten if you would have decided that 10 minutes wasn’t worth it. 

  • Find ways to move in your everyday life.
    • Standing desk
    • Walk on treadmill and watch your favorite show
    • 5 minutes of stretching before bed
    • Walk around office for 5 minutes every hour (grab water, talk to a coworker, look out the window)
  • Find movement that you truly enjoy
    • Exercise doesn’t have to mean going to the gym or going for a run. It could also mean hiking with a friend, rock climbing, going for a slow walk, dancing to your favorite songs, gardening, deep cleaning your home, or swimming at the pool. 

4. Mindful Eating

Incorporating mindfulness into your eating routine can help overtime to manage weight. Although mindful/intuitive eating is not meant for weight loss, studies have shown that it is often associated with weight loss and higher intakes of fruits and vegetables (6). 

  • Identify your hunger and fullness cues.
    • Slow down during meals and try to eat meals undistracted. This will help you to tune into your fullness cues. 
    • Pay attention to your hunger cues during the day, try to have a snack or a meal when you are getting hungry instead of waiting until you are overly hungry. When we are overly hungry, most people do not make the best choices. 
  • Incorporate your craving foods regularly.
    • You do not need to eliminate or avoid any foods to lose weight with PCOS. Try incorporating them in a balanced way.
      • Add protein, fats, and fiber
      • Examples (M&M’s with greek yogurt and raspberries, french fries with baked salmon and broccoli)
    • Enjoying these foods instead of avoiding them allows you to be satisfied by smaller amounts. When we avoid foods completely and let the craving build, opportunities for overeating or binging on these foods increase. 

5. Stay Consistent

Last but certainly not least, make sure the changes that you make are changes that you can stay consistent with. Implementing new habits for 2 months and then going back to the same habits as before does not help you in the long run. 

Avoid crash diets since the majority of them can not be continued for the long term. They are quick fixes and will lead you to the exact same place you started from or even worse off. 

Instead, choose 1-2 goals per week of small and easy changes to implement. Build on these slowly over time. This creates habits that will feel more sustainable for you to keep and will aid in your long term weight loss success. 

This also includes staying consistent on weekends. Try to make your meals fun all week and incorporate fun foods in so that you do not feel the need to over indulge on weekends. 

Indulging too much on the weekends after restricting during the week can ruin your weight loss goals when done repeatedly. 

Final Thoughts 

Remember that weight loss looks different for everyone and try your best not to compare your journey to anyone else’s. Remember that you are in this for the long haul, keep your eyes ahead of you. 

It is also important to remember through this journey to enjoy your food and not to stress too much about an “imperfect” meal. If you ate too many calories or had dessert when you felt you shouldn’t, try to enjoy it and move on to your regular meals.

This analogy may be helpful for you. If one salad is not going to make you meet your weight loss goals, then one high calorie meal is not going to ruin your weight loss goals either. In any weight loss journey, it is important to find balance. 

In this article, we reviewed what PCOS is, how it affects weight loss, and 5 strategies to lose weight with PCOS. The next step is meal planning so that you can stay on track and have the best chance of success. Check out my guide on meal planning here for more details.

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