Weight Loss and Polycystic Ovary Syndrome

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Women with PCOS often find they can’t lose weight. There’s a good reason why so many people struggle with their weight, and it has to do with the hormone insulin.

Insulin is a growth hormone. Insulin’s main job is to promote fat storage or weight gain. Compared to women without PCOS, women with the condition have higher levels of insulin. It’s not uncommon to hear women with PCOS report rapid weight gain of 20 to 30 pounds despite a healthy diet and exercise regimen.

Insulin is also an appetite stimulant, which is why many women with PCOS struggle with intense, almost urgent cravings for carbohydrates and sweets. High insulin levels may also contribute to binge or emotional eating.

Despite the difficulties women with PCOS face to manage their weight, they are often told by healthcare providers to lose weight. This is because weight loss has been shown to improve menstrual regularity and metabolic parameters.

It can be a challenge for women with PCOS to lose weight when they are in fat storage mode, but it can be done. Here are some ways to help.

Lifestyle Changes

The primary treatment approach for women with PCOS is with lifestyle changes involving your eating, physical activity, sleep, and your ability to better manage stress.

Healthy Eating

A healthy diet is key to managing PCOS. Foods that contribute to raising insulin levels should be cut out or limited. These include sugary beverages, processed foods like crackers, chips, and breads, as well as baked goods and desserts.

Instead, focus on foods that have been shown to reduce insulin and inflammation. These foods include fruits, vegetables, nuts, and legumes. These are also the best foods to help you reach your weight loss calorie goals.

Spreading carbohydrate foods evenly throughout the day with moderate amounts at meals and snacks can also help keep insulin down.

Physical Activity

Regular physical activity is an effective way to bring down insulin levels and help with weight management. It’s recommended that American adults engage in at least 75 to 300 minutes of moderate to vigorous physical activity per week with at least two days of strength training. Strength or resistance training can help build muscle, which can burn more calories.

If finding time or having the ability to do 60 minutes of exercise seems daunting, try breaking it up. For example, try a 30-minute weight training session and two separate 15-minute walks. If you’re currently inactive, start with what seems most doable to you with an activity you​ ​enjoy.


There is strong research showing that​ lack of sleep contributes to insulin resistance and weight gain. Most women need around eight hours of sleep each night. Making sleep a priority by going to bed at an earlier time can help. Tips for a better night's sleep include keeping the room cool and dark and having a comfortable pillow and mattress. Avoiding screens (TVs, phones, tablets) at least 30 minutes before bed can also improve your chances of a better night’s rest.

Many women with PCOS suffer from obstructive sleep apnea, resulting in less oxygen and reduced quality sleep. There is a link between sleep apnea and insulin resistance. If you’ve been told you snore, have high blood pressure, or are constantly tired throughout the day, talk to your doctor about getting a sleep study. Treatment of obstructive sleep apnea can bring down insulin levels.


Consistent high levels of stress can have a big impact on insulin and weight gain. Stress can increase the hormone cortisol, which directly increases insulin. One way to manage stress is with exercises like yoga. Some find floating, meditation, and mindfulness practices beneficial. If you are having trouble managing your stress levels, consider talking with a licensed psychologist.

Other Treatments

Even with lifestyle changes, women with PCOS can still struggle to lose weight. If this is the case, there are some supplements and medications to help. While these aren’t specifically for weight loss, they can bring down insulin levels when combined with a healthy lifestyle:

Weight Loss Surgery

Like weight loss in general, weight loss or bariatric surgeries have been found to be effective at improving fertility and metabolic complications. A study in Obesity Surgery showed that weight loss surgeries can improve many symptoms of PCOS, including hirsutism and menstrual irregularity in severely obese women.

Weight loss surgeries should only be considered as a last resort, after women with PCOS have gotten help in making lifestyle changes and trying different medications or supplements.

Help When You Need It

If you’re struggling to lose weight, don’t be afraid to ask for help. A registered dietitian nutritionist (RDN) who specializes in PCOS can help you find an eating plan that works for you. If you struggle with binge or emotional eating, an RDN can help you to stop these behaviors and help you become a more mindful eater.

Likewise, if you aren’t sure how to begin weight training or need to change your workouts, consider working with a personal trainer.

A Word From Verywell

There is no magic weight loss fix for PCOS. As tempting as they are, avoid being sucked in to fad diets that promise fast weight loss. Instead, focus on sustainable lifestyle changes that will help you lose weight and keep it off in the long-term.

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Article Sources

  1. Teede HJ, Joham AE, Paul E, et al. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women. Obesity (Silver Spring). 2013;21(8):1526-32. doi:10.1002/oby.20213

  2. U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition Executive Summary. Published 2018.

  3. Van cauter E. Sleep disturbances and insulin resistance. Diabet Med. 2011;28(12):1455-62. doi:10.1111/j.1464-5491.2011.03459.x

  4. Skubleny D, Switzer NJ, Gill RS, et al. The Impact of Bariatric Surgery on Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis. Obes Surg. 2016;26(1):169-76. doi:10.1007/s11695-015-1902-5

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