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It's incredibly common for women with PCOS to struggle with overweight or obesity. If you have PCOS, your body may be working against you — but these scientifically-proven steps can help you lose weight.

A shocking 80 percent of American women with polycystic ovary syndrome may be obese, some research indicates — though in some other countries, only one in five PCOS sufferers struggle with obesity. Obesity represents an exceptional challenge. Not only does PCOS increase your risk of becoming obese as insulin resistance is so common in women with this condition, once you're there, your symptoms — and your insulin resistance — are also likely to get worse. 

The relationship between insulin resistance and obesity can probably best described as a vicious cycle, one exacerbating the other, but there are also other side effects; high insulin means higher androgen levels, and that can in turn lead to hirsutism, acne, and unpredictable menstrual cycles. Excessive androgen production also, you guessed it, contribute to yet more weight gain, especially around the abdomen. This kind of fat, called central obesity, increases your odds of developing heart disease. 

There is yet another problem, though. Hormones that control how much of an appetite you have, ghrelin, cholecystokinin, and leptin don't function the way they should in PCOS patients, either, causing you to feel hungrier than you should. 

You've got a lot of odds working against you, then, and battling weight gain with PCOS sounds almost impossible. What can we learn from countries where women with PCOS are less likely to be obese? Your treatment approach should, of course, start with an experienced doctor who is up to date on PCOS-related research. There are also, however, steps you can take at home to lower your weight. It's important to make this a priority, as having a healthy body weight is the number one factor that will help relieve your symptoms, improve your fertility, and reduce your risk of other adverse health outcomes.

1. Lower your calories

"OK, Captain Obvious, I thought of that one already." Yeah, we know, but making sure you don't take in more calories than you burn is still one of the most important things you can do to not gain more weight, and creating a caloric deficient is still one of the best ways to shed pounds. So we've gotta mention it. 

So, how many calories should you aim for in a day? That actually depends on your current weight and level of physical activity, as well as your metabolic rate. It's best to ask your doctor, but for reference, one study indicated that women with PCOS benefit from a caloric intake of between 1200 and 1500 calories a day, while another study showed that consuming 1800 a day will likely maintain your current weight. That may seem like very little, but many of the study participants were obese, so if you are too, these may indeed be the right numbers for you. 

Besides the amount of calories you take in, what they are and when you eat them also matters. Research revealed that eating a big breakfast but going for smaller meals later in the day can fight insulin resistance, improve the frequency of ovulation, and also lower androgen levels. If you want to try this, be sure to include protein and carbs in your breakfast.

2. Is metformin right for you?

Metformin is a diabetes drug that is prescribed to women with PCOS quite often. Not only does it promote better insulin levels, metformin also lowers testosterone levels. This combination makes metformin very useful for PCOS patients who are struggling with obesity and have not been able to get their weight down by other means.

3. A low glycemic index diet

A low glycemic index diet is, many people have been saying for ages and research has now also indicated, extremely beneficial for women who PCOS who are overweight and have insulin resistance. This kind of diet improves your cardiovascular health and helps regulate your menstrual cycles. 

Will a low GI diet help you lose weight? Maybe, yes, but the study demonstrated that even if you just lose four to five percent of your total weight, low GI diets have three times the positive impact on your insulin sensitivity than conventional healthy diets. A low glycemic index diet also, the study found, reduces blood lipid (fat), lowers androgen levels, and helps fight inflammation. Better health often leads you to feel better emotionally, as well, so it is no surprise that women with PCOS following a low GI diet also reported increased overall wellbeing. 

4. A well-balanced diet and smaller, more regular, meals

So, we all know that highly-processed junk foods rich in fat and sugar aren't great for our health. It's important to include veggies, fruits, and whole grains in your diet, to give you lots of fiber, vitamins, and minerals. What exactly should a healthy meal look like, though? Try aiming for:

  • 52 percent carbs 
  • 18 percent protein
  • 30 percent (healthy!) fats

You can achieve this by eating lots of veggies, fruits, and whole grains as well as dairy products (ideally low-fat) and lean meats. Getting all these foods in through smaller meals that you eat more often, about six a day rather than three big ones, will help maintain steady blood sugar levels.

5. Say no to binge eating

Most of us overindulge in food sometimes, but women with PCOS are also more prone to developing binge eating disorder. Over half, research has shown, have some kind of issue with binge eating. Nope, not simply because you "can't control yourself" — body chemistry plays a role here, too, as ghrelin — a hormone that regulates the appetite — works differently in PCOS patients. Your ghrelin levels would typically fall quite rapidly after eating, signaling that you are now full. In women with PCOS, however, ghrelin drops more slowly, meaning you may not feel full when you've already eaten enough. This is why it is extra important to be aware of your caloric intake and to avoid binge eating.

6. Regular exercise

Exercise should be included in nearly everyone's life, and it plays an important role in facilitating weight loss. In PCOS patients, working out regularly — both cardio and strength training, about five times a week for half an hour — also increases insulin sensitivity. Engaging in strength training three times a week will help you build muscle mass, and slim down extra abdominal fat. It also, amazingly, helps you burn more calories even when you're not exercising, because muscle requires more energy than fat tissue. Cardio, meanwhile, reinforces the benefits you're getting from strength training, and promotes cardiovascular health. 

Don't feel ready for a full-on exercise routine yet, or has your doctor advised you against it? Even just walking 7500 a day will bring down your weight, your waistline, and your androgen levels!

7. Stop smoking

This one won't apply to everyone, of course, so if you're already a non-smoker, you can stop reading now. If you do smoke, you know it's bad for you. You may not be aware that smoking is even worse for those who live with PCOS than for the general population, mind you, as it:

  • Increases your risk of heart disease, something you're already more likely to face if you have polycystic ovary syndrome.
  • Deceases your "good" (HDL) cholesterol while increasing your "bad" (LDL) cholesterol. 

Many current smokers are worried that quitting nicotine will cause them to pile on extra pounds. While this may be true in the short term, as stopping smoking changes your metabolism and can also cause food cravings as you try to avoid cigarettes, this will only last for a while. A healthy diet and exercise can both help you with your quitting process and prevent quitting-related weight gain.

  • Eman M. Sayed Ahmed, Mohamed E. Salem and Mohamed Samir Eid Sweed Effect of Lifestyle Modifications on Polycystic Ovarian Syndrome Symptoms. J Am Sci 2012,8(8):535-544]
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