Why It's So Hard to Lose Weight With PCOS

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If you have polycystic ovary syndrome (PCOS) and find it hard to lose weight, you are not alone. More than half of all people with PCOS are overweight. Advice from healthcare providers is to lose weight, but those with this syndrome know it’s not that easy. Here are reasons that explain why it’s so much harder to lose weight with PCOS.

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Your Body Is in Fat Storage Mode

Insulin is a hormone that transports glucose (your body’s main source of fuel) from your bloodstream into your cells where it can be used as energy. PCOS affects your body's secretion and use of insulin. Your cells become resistant to insulin signals and this prompts your pancreas to produce even more insulin.

Too much insulin promotes fat storage or weight gain, mostly in your midsection, resembling a “spare tire” above your belly button.

If you are gaining lots of weight or can’t lose weight without significant changes in diet or exercise routines, excess insulin could be the culprit.

Treatment options for PCOS are typically aimed at reducing insulin levels and involve diet modifications, exercise, and medications or supplements.

You’re Hungrier

As part of promoting fat storage, insulin acts as an appetite-stimulating hormone. High levels of insulin could explain why some people with PCOS experience more hunger. Strong, intense, even urgent cravings are reported in women who are insulin resistant.

If not managed, these cravings can sabotage even the best eating habits, leading to higher calorie consumption and weight gain. Eating often, including sufficient protein with meals, and avoiding sugary foods are all helpful ways to reduce cravings.

Impaired Appetite-Regulating Hormones

Another possible factor that could make weight loss and weight maintenance difficult for people with PCOS is abnormal hormonal influences that regulate appetite and satiety.

Levels of appetite-regulating hormones ghrelin, cholecystokinin, and leptin have been shown to be impaired in women with PCOS. Dysfunctional levels of these hormones may stimulate hunger in people with PCOS, resulting in increased food intake and difficulty managing weight.

Your Diet Is Imbalanced

If you’ve been watching your diet and still aren't seeing the pounds come off, it could be the types of foods you are eating.

A 2010 study compared a low glycemic index diet to a regular, healthy fiber diet in women with PCOS. Both groups ate the same amount of calories and consumed the same distribution of macronutrients (50% carbohydrates, 23% protein, 27% fat, 34 grams fiber).

The only difference was the glycemic index (GI) of foods. The women with PCOS who followed the low GI diet showed a three-fold greater improvement in insulin and had better menstrual regularity. These findings suggest that those with high insulin levels may be able to lose more weight following a low glycemic index diet.

Not eating enough fruits and vegetables can also impact weight loss. A study found that women with PCOS who followed the Dietary Approaches to Stop Hypertension (DASH) eating plan showed improvements in insulin and abdominal fat loss.

The DASH diet consisted of 52% carbohydrates, 18% protein, and 30% total fats, and rich in fruits, vegetables, whole grains, and low-fat dairy products.

You Have Obstructive Sleep Apnea

Women with PCOS are at a much higher risk for obstructive sleep apnea compared with women without the condition. Obstructive sleep apnea occurs when there is a blockage of the upper airway that causes a lack of oxygen during sleep. This results in daytime sleepiness, high blood pressure, and weight gain.

While excess body weight is a main contributing factor to sleep apnea, high levels of androgens (male hormones such as testosterone) seen in PCOS, are believed to play a role in affecting sleep receptors. Lack of sleep is associated with insulin resistance and weight gain.

The more severe sleep apnea is, the higher the risk of impaired glucose tolerance, which is why it’s recommended that all women with PCOS get screened for obstructive sleep apnea and receive proper treatment if diagnosed.

Frequently Asked Questions

  • How can you lose weight with PCOS?

    Start by eating a variety of healthy foods, including fruits and vegetables, and making exercise part of your daily routine. If you're having trouble losing weight, lowering your carbohydrate intake and increasing proteins may help. In a six-month trial, a diet with a higher ratio of protein to carbohydrates led to greater weight loss for people with PCOS. Check with your doctor or dietitian to help you develop a plan that's right for you.

  • Can you lose weight with metformin if you have PCOS?

    It's possible. Metformin is a diabetes medication that's sometimes prescribed for PCOS. It improves insulin sensitivity and helps control blood sugar. Some studies have found that among people who were receiving hormone therapy for PCOS, those who took metformin and made lifestyle changes lost more weight.

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10 Sources
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