In the United States, Polycystic Ovary Syndrome (PCOS) affects 6-12% of women, according to the Centers for Disease Control and Prevention. For women with a PCOS diagnosis, it can affect many aspects of their health, especially weight, and losing it can feel impossible.
But what is PCOS, exactly? “PCOS is a complex metabolic syndrome that affects nearly every system of the body including the ovaries, adrenal glands, pituitary gland, and more. It is characterized by irregular menstrual cycles, high androgens, and polycystic ovaries (ovaries that have more than 12 follicles each),” says Melissa Groves, RDN, LD and author of A Balanced Approach to PCOS: 16 Weeks of Meal Prep & Recipes for Women Managing Polycystic Ovarian Syndrome.
Unfortunately, PCOS raises the risk for infertility, diabetes, heart disease, and certain gynecological cancers. And women often experience many other symptoms as well. “Women with PCOS have infrequent, heavy and prolonged periods, in addition to difficulty getting pregnant and struggles with acne and abnormal hair growth on the chin and chest and even male pattern balding,” says Dr. Dana Elborno, MD, OB/GYN at Northwestern Medicine Central DuPage Hospital.
One of the most common side effects of PCOS? Weight gain and difficulty losing weight.
“Most women with PCOS have insulin resistance, hormone imbalances, and adrenal dysfunction that can make losing weight feel impossible,” says Groves.
Libby Mills, MS, RD, LDN, FAND, registered dietitian and spokesperson for the Academy of Nutrition and Dietetics adds, “Women with PCOS struggle to lose weight because of the insulin resistance and resulting high blood sugar. When blood sugar is too high and not being used for energy, then it will be stored as fat. This can raise the body mass index (BMI), which in turn can add to the insulin resistance.”
So, what can you do if you want to lose weight and have PCOS? Here's what to know.
How to Lose Weight With PCOS
As discouraging as some of these facts around PCOS and weight loss are, losing weight with PCOS isn't impossible. Here are 10 ways to make it happen.
Eat more fiber
“Most people do not get nearly enough fiber, which is found mainly in fruits, vegetables, legumes, and whole grains. Fiber helps keep us full and slows the absorption of glucose into the bloodstream,” says Groves. “Studies have linked a higher intake of fiber in PCOS to lower weight, body fat, and belly fat, as well as improvement in insulin sensitivity. The recommendation for women is 14 grams of fiber per 1,000 calories consumed, or around 25-28 grams a day. I recommend including fiber in every meal and snack.”
Adds Dr. Elborno, “Bulgur wheat, barley, quinoa, oatmeal, whole wheat pasta or bread are all great options.”
And you should also put an emphasis on veggies. “There is no rule saying that you can’t have more veggies like zucchini, asparagus, broccoli, tomatoes and pepper,” says Mills. “Filling up on more vegetables works because the fiber and water in these vegetables will help fill you up and keep you fuller between meals on fewer calories.”
Related: 20 Best High Fiber Snacks
Eat protein consistently throughout the day
“Protein helps stabilize blood sugar and increases satiety after a meal, which may help decrease cravings and lead to eating fewer calories overall,” says Groves. “A higher-protein diet in PCOS has been linked to weight loss. I recommend women with PCOS aim for 25-30 grams of protein per meal and 8-10 grams per snack.”
Related: The Best High Protein Foods
Eat a "healthy" plate
“In general, PCOS-friendly diets should divide calories during the day into 40% carbs, 45% fats and 15% protein. This division of calories has been shown in studies to decrease insulin levels and improve weight loss measures in PCOS patients,” says Dr. Elborno. “An easy and stress-free way to maintain these ratios is to follow the Harvard Healthy Plate model. Divide up your plate into quarters. Keep half the plate for raw salad or steamed veggies, one-fourth of the plate for a lean protein and one-fourth of the plate for whole grains. Use healthy fats like coconut oil and olive for cooking and to drizzle over your veggies. Do this at every meal, including breakfast. Yes, you can and should have veggies for breakfast! This keeps you on track to maintain those ratios.”
“Eating a breakfast that is high in protein, healthy fats, and fiber helps set you up for a more stable blood sugar day. Many women are under-fueling throughout the day and then wondering why they're having cravings and binges in the afternoon and evening,” says Groves. “Studies have shown that eating a high-protein breakfast can help reduce appetite throughout the day and that women with PCOS who eat a larger breakfast have improvements in markers such as insulin resistance and androgen levels.”
Eat smaller, more frequent meals
“Eating smaller, more frequent meals helps maintain blood sugar in a healthful range. This may mean eating four to five smaller meals each day. Maintaining blood sugar in a healthy range prevents highs in blood sugar. When blood sugar is too high and is not being used for energy, then it will be stored a fat,” says Mills. “These mini-meals need to include some lean protein or low fat-dairy, plenty of fiber from legumes, whole grains fruits, a good amount of vegetables and some healthful fat from nuts, seed, avocado or healthful oil like olive oil or canola oil.”
Increase your intake of healthy fats
“Patients with PCOS are at higher risk of developing high cholesterol for several reasons, including their imbalance of estrogen, progesterone, and testosterone,” says Dr. Elborno. “Increasing your intake of unsaturated fats and avoiding saturated fats can be protective and decrease your risk for atherosclerosis and coronary heart disease over the long run.”
Eat an anti-inflammatory diet
“The link between inflammation and obesity is well established. Inflammation increases obesity and obesity worsens inflammation in a vicious cycle. An anti-inflammatory diet pattern that is high in fruits, vegetables, and omega-3 fatty acids from fatty fish and nuts (such as the Mediterranean diet) has been linked to improvements in inflammatory markers, weight, and health in general,” says Groves. “To eat an anti-inflammatory diet, focus on whole foods and minimize inflammatory fats from vegetable oils (peanut, safflower, etc), processed foods, and added sugars.”
Related: 100+ Anti-Inflammatory Food Ideas
Minimize added sugars
“Added sugars contribute a large proportion of calories to the American diet and an excess of added sugars makes blood sugar balance more difficult to achieve, which can worsen insulin resistance,” says Groves. “The U.S. guidelines recommend that no more than 10% of daily calories come from added sugar; the WHO guidelines recommend no more than 5%. For someone eating a 2,000 calorie a day diet, 5% of calories would translate to eating no more than 25 grams a day of added sugar, which is a reasonable guideline for women with PCOS wanting to lose weight.”
Related: Birth Control for Treating PCOS
“Movement improves insulin sensitivity. This can be as simple as moving the arms in circles, waist bends or pacing the room when on a phone call. Moving for longer periods of time, with greater intensity and variation, will not only improve insulin sensitivity, but will burn more calories, condition the heart and other muscles and improve strength, balance and endurance,” says Mills. “Maintaining and building lean body mass by regularly challenging muscles to work helps the body burn calories, even after you’ve finished exercising. Small bouts of activity are reviving during the day and can stimulate a positive outlook and rev your energy level.”
Choose healthy snacks
“Ensuring you have a healthy snack in between meals keeps your metabolism energized and fights against your body's inclination towards fat storage. Snacks are a great place to sneak more lean proteins and healthy fats into your diet,” says Dr. Elborno. “Think egg whites and olive oil, tuna and avocado, almonds and turkey slices to tip you your metabolic balance into fat burning.”
Next up, what is the best diet for PCOS?
Dana Elborno, MD, OB/GYN at Northwestern Medicine Central DuPage Hospital.
Libby Mills, MS, RD, LDN, FAND, registered dietitian and spokesperson for the Academy of Nutrition and Dietetics.
Nutrients: “Ten-year trends in fiber and whole grain intakes and food sources for the United States population: National Health and Nutrition Examination Survey 2001-2010.”
Clinical Nutrition: “Dietary intake, body composition and metabolic parameters in women with polycystic ovary syndrome.”
Clinical Endocrinol: “Increased fibre and reduced trans fatty acid intake are primary predictors of metabolic improvement in overweight polycystic ovary syndrome - substudy of randomized trial between diet, exercise and diet plus exercise for weight control”
Mayo Clinic: “Nutrition and healthy eating.”
American Journal of Clinical Nutrition: “Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome.”
Gynecol Endocrinol: “Substituting poly- and mono-unsaturated fat for dietary carbohydrate reduces hyperinsulinemia in women with polycystic ovary syndrome.”
Harvard School of Public Health: “Healthy Eating Plate.”
Clinical Science: “Effects of caloric intake timing on insulin resistance and hyperandrogenism in lean women with polycystic ovary syndrome.”
Advances In Nutrition: “A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management.”
North American Journal of Medicine & Science: “Anti-Inflammatory Dietary Combo in Overweight and Obese Women with Polycystic Ovary Syndrome.”
BMJ: “Ultra-processed foods and added sugars in the US diet: evidence from a nationally representative cross-sectional study.”
Fertility and Sterility: “Effects of protein versus simple sugar intake on weight loss in polycystic ovary syndrome (according to the National Institutes of Health criteria).”
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