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Losing weight with PCOS is important if you're overweight or obese, but it's also easier said than done. We have some tips for you.

It's not at all unusual to be overweight or obese when you have Polycystic Ovary Syndrome, but having a high body mass index greatly increases your risk of suffering from infertility, type 2 diabetes, and heart disease. Losing weight with PCOS should, therefore, be a priority for any woman with Polycystic Ovary Syndrome who is overweight, regardless of whether she's trying to get pregnant. 

It's also, as you may already have found out, often easier said than done. 

How can women with Polycystic Ovary Syndrome lose weight, and what is the best PCOS diet?

Not Sure You Have PCOS? A Brief Look At Polycystic Ovary Syndrome

Polycystic Ovary Syndrome, also often called Polycystic Ovarian Syndrome by laypeople, is an endocrine (hormonal) disorder that leads to excessive levels of hormones called androgens, which are produced by the ovaries in women. PCOS can have a great impact on your general health and appearance — it affects your metabolism, your menstrual cycle, and leads to multiple cysts in the ovaries, as the syndrome's name suggests. Women with PCOS frequently suffer from infertility, over half of PCOS patients have insulin resistance, and Polycystic Ovary Syndrome has also been linked with depression, anxiety, and binge eating disorder. [1]

Depending on which diagnostic criteria are used, up to a fifth of all women may suffer from PCOS. [1]

Since symptoms usually set in right after you start menstruating, though, women with PCOS may simply have come to see their way of experiencing their body as normal, and may not realize they even have PCOS.

If you suspect you could have Polycystic Ovary Syndrome but aren't sure, a list of PCOS symptoms should be a helpful starting point:

  • Irregular periods. Women with PCOS may have unpredictable menstrual cycles, miss some periods, or have periods more often than usual (every 21 days, for instance). Their periods may be very light, but they can also be prolonged and unusually heavy. 
  • Unusual hair growth. The excess androgens seen in women with PCOS can cause body hair to appear in places where women do not usually have it, such as on the face and chest. This is called hirsutism. Women with PCOS may also notice thinning hair on their head, called androgenic alopecia. 
  • Weight gain or difficulty losing weight. Polycystic Ovary Syndrome is closely associated with weight gain and difficulty losing weight despite dieting. 
  • You may also notice acne, skin tags, and topical darkening of your skin along creases (in the groin or armpit area, for example.) [2]

Those women who recognize themselves in one of these symptoms do not necessarily have PCOS — PCOS is a syndrome, after all, and that means a medical condition characterized by a set of symptoms in combination. While you are absolutely right to approach your doctor if you notice just one of these symptoms, you are most certainly advised to seek medical help if all of these symptoms apply to you. If you do have PCOS, it is important that you receive a correct diagnosis; Polycystic Ovary Syndrome is linked to type 2 diabetes, decreased cardiovascular health, and infertility. [3]

Why Lose Weight If You Have PCOS?

If you are overweight or obese, losing weight with PCOS is important for the same reasons everyone else benefits from maintaining a healthy weight — at a healthy weight, you will have more energy, a better-functioning immune system, a reduced risk of heart disease and stroke, and less pressure on your joints. 

Losing weight with PCOS is also important for a few reasons directly related to Polycystic Ovary Syndrome, however. 

One study showed that overweight and obese women who took part in a weight loss program that included information about diet, exercise, and mental health and who lost an average of around six kilos each, attained great success in returning to ovulatory menstrual cycles and thus improved their fertility. In addition, their insulin and androgen levels went down and their self-esteem went up. [4] Losing weight with PCOS is not only beneficial for those who are hoping to achieve a spontaneous pregnancy, either — research also shows that weight loss greatly improves the outcome of various fertility treatments. [5]

Weight loss likewise improves your insulin resistance and lowers your risk of developing type 2 diabetes if you do not already have it, another convincing reason to attempt to lose weight if you suffer from Polycystic Ovary Syndrome [6]. 

What's more, your menstrual cycle is likely to become a whole lot more regular, and possibly less torturous, if you manage to lose just 10 percent of your current body weight. [2]

OK, I Understand Losing Weight With PCOS Is Important, But How Do I Do It?

Good question. 

You have a few different options, and should generally start with the least invasive option and work your way up, in consultation with your treating doctor or doctors:

  • "Traditional weight loss methods", in other words, dietary and lifestyle adjustments. More about that later. 
  • Metformin, a medication used to control blood sugar levels in people with type 2 diabetes, can also help you lose weight. [7]
  • Hormonal contraceptives, such as the birth control pill or the Mirena intrauterine system, can help lower androgen and insulin levels in women with PCOS who do not currently wish to get pregnant. [8]
  • Bariatric surgery can greatly improve PCOS symptoms, including excess hair growth, in morbidly obese women with Polycystic Ovary Syndrome. [9]

I Want To Try To Lose Weight By Myself With A Diet Plan For Polycystic Ovary Syndrome: How Does That Work?

Poke around the web in search of a "PCOS diet", and the advice you'll find is rather varied. There's a reason for that. Research indicates that obesity is a serious problem among women with Polycystic Ovary Syndrome — around 44 percent of all PCOS patients are obese [10]. We also know that losing weight offers enormous benefits, as you've already seen. What hasn't been studied widely, however, is exactly how women should go about losing weight with PCOS, that is, what diet plan for Polycystic Ovary Syndrome is best. 

Thankfully, there is one study that addresses the exact diet you're best off following: women who follow a low glycemic index diet see a greater reduction in their PCOS symptoms than those following a conventional healthy diet, even where both lose weight. This has a lot to do with reduced insulin resistance. [11]

Another study that compared Italian women with PCOS to American women with PCOS found that the Italian participants had lower levels of obesity. Interestingly, the total caloric intake was very similar across both groups, as was their total carb, protein, and fat intake. The one significant difference was that the Italian group consumed significantly less saturated fat. [12]

From these two studies, we can learn that it is best to follow a low glycemic index diet and to go easy on the saturated fats to the best of your ability, if losing weight with PCOS is your goal. 

Low GI foods are those with a glycemic index of less than 55 — and Harvard Medical School has a handy list for you to check out. [13] Saturated fats, meanwhile, occur naturally in many foods, including things like butter and pork. They should make up no more than about six percent of your total calories, but you do not have to avoid them completely. [14]

What does that mean in real terms? If you are trying to follow a low GI diet for your PCOS and you are hoping to keep saturated fats to a minimum as well, your meals may look a little something like this. 

  • Breakfast: Oatmeal made from scratch, with non-dairy milk like soy milk, and topped with a fresh, sliced banana. (Most commercial cereals have a pretty high glycemic index, so you'd be best off avoiding those.)
  • Lunch: A quinoa salad with fresh tomatoes, cucumber, grilled pepper and zucchini (with extra virgin olive oil), and grilled chicken. 
  • Dinner: Steamed cod with oven-baked sweet potato chips and a simple cucumber salad with dill and reduced-fat yogurt.

Or:

  • Breakfast: Half an avocado topped with fresh coriander and lemon juice, with a slice of whole-grain bread and a boiled egg. 
  • Lunch: Lentil soup with onions, garlic and tomato puree. 
  • Dinner: Whole-wheat pasta with scampi, garlic, scallions, a dash of white wine, and olive oil.  

Your caloric needs depend on your age and level of activity. Most adult and premenopausal women need somewhere between 1,800 and 2,400 calories a day [15], but those who are trying to lose weight should both choose fewer calories, and engage in regular physical activity:

  • strength training three times a week,
  • and cardio at least twice a week. 

It's best to consult your doctor for advice or a referral to a dietician so that you will have access to a medically-supervised, tailor-made PCOS weight loss plan. 

If losing weight with PCOS while following a low GI diet is proving to be harder than you thought, it's time to ask for Metformin, which makes a low GI diet much more effective for PCOS patients [11]. 

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