If you’ve been diagnosed with PCOS, you may have first suspected something wrong when you gained weight unexpectedly or had a hard time losing weight.

What is PCOS?

Polycystic Ovarian Syndrome (PCOS) is a gynecological health condition characterized by small, numerous cysts on the ovaries.  Most commonly, it occurs alongside insulin resistance and elevated male hormones like testosterone with irregular or absent menstruation.

Women with PCOS often have elevated levels of estrogen and are at higher risk for conditions like endometrial cancer and infertility.

Despite the many symptoms of PCOS like excessive facial and body hair and lack of ovulation, the excess weight of PCOS is what causes the most distress for many women.

It may surprise you to learn that PCOS can occur both because of excess weight and can also encourage excess weight gain.  

Many women with PCOS are of normal body weights but struggle to maintain their figure because of imbalanced hormones and insulin resistance. Some women menstruated normally at normal body weights but, after gaining excessive weight, developed PCOS symptoms.  For these women, losing weight is often a highly effective tool for restoring normal hormonal balance.

Weight loss can also be beneficial for women with normal BMI who still carry excessive fat in the abdominal region.  This is characteristic of insulin resistance.

Women with PCOS can live happy, healthy, energetic lives and maintain normal weights with some changes in lifestyle. 

Some women with PCOS will need more help than others.  If you need individualized attention, I offer distance consultations and programs to help you succeed.  Find more on my contact page.

If you’re ready to make some changes and take back your health, here are my top 3 ways to lose weight with PCOS. 

#1 Whole Foods Anti-inflammatory Diet

The number one goal of PCOS nutritional treatment is the control of insulin and blood sugar.  

Most women with PCOS have what is called hyperinsulinemia.  This means that they produce excessive insulin (compared to the average person) with every bite they eat, especially foods that contain starchy carbohydrates like bread, pasta, and sugar.

This means that women with PCOS can go a long time without developing diabetic symptoms and have normal blood glucose readings.  However, they can be damaging their metabolism and hormonal health.  Insulin is a hormone and it is excessive insulin that causes the most common hormonal imbalances of PCOS.

To control insulin, it is important for women with PCOS to follow a regular diet.  Many diets have been shown to provide benefit for women with PCOS.

Low carbohydrate diets have shown a lot of promise because the reduction in carbohydrates causes a reduction in insulin production.  The Mediterranean diet with it’s focus on good fats has shown benefit as well.  Even low calorie diets have been shown to improve insulin resistance because less food means less insulin coursing through the body.

Because low-carb diets allow women with PCOS to eat more food than low calorie diets, they are usually easier to stick to.  Just make sure that you include lots of non-starchy vegetables in any low-carb diet plan.

Different diets work for different people.  Because women with PCOS often struggle with chronic inflammation, it is important to make sure that whatever diet is chosen, it is made up of whole, unprocessed foods, primarily cooked at home, and anti-inflammatory non-starchy vegetables like leafy greens, broccoli, and others.  

Good fats including saturated fat like coconut oil and even lard and tallow from grass-fed animals, monounsaturated fats like olive oil and avocado, and fats with high levels of Omega 3 fatty acids like that found in salmon, are all good choices.  

Just as importantly for anti-inflammatory diets is to exclude certain things.

High starch foods like french fries, bread, pasta, and foods cooked in unsaturated oils like canola, soybean, or corn oil should all be avoided.  Foods made in restaurants typically contain these rancid oils and are not a good idea most of the time.  

Fried foods contain such a high caloric value, along with heavy starch that they are not great choices for women with PCOS and sugary desserts, even those made with natural sweeteners like honey or coconut sugar should be very rare. 

It is very beneficial for women with PCOS to be tested for food sensitivities, as sensitivities to dairy, eggs, or grains are very common and can exacerbate inflammatory symptoms.  I have had a lot of success with food sensitivity testing in my practice and have access to testing that has a much higher than average accuracy rate.  These kits can also be done from home and used with distance clients, so contact me if you would like to pursue testing.

#2 Supplements and Exercise

Several supplements have shown benefit in improving insulin resistance in women with PCOS.  But no supplement can replace the value of a healthy diet and exercise regimen.

Women with PCOS should focus on strength training alongside cardiovascular movement. I recommend weight lifting 3 times a week along with a long walk each day.  Stay moving throughout the day as best you can, taking breaks to get up and walk every hour.  Try incorporating yoga into your life at least once a week. 

Exercise directly improves insulin sensitivity in the muscles and is one of the most important parts of losing weight with PCOS.  While it can be tough to work up the energy to exercise at first, you’ll find that the more you do it, the more you enjoy it and the better you feel. 

Don’t worry about things like running.  Walking long distances has been shown to have just as beneficial an effect on the body as jogging, and in some cases more.

As far as supplements go, several have been shown to help.

Myo-inositol and D-chiro inositol (I like this combination supplement) have both been shown to improve insulin sensitivity in women with PCOS as well as improve ovulation rates. 

L-carnitine (Like this one) has been shown to be lacking in many women with PCOS and including it has been shown to improve insulin sensitivity and induce weight loss.  

Alpha Lipoic Acid (like this one) has been shown to be anti inflammatory and helpful for women with PCOS.  

Because many women with PCOS have the MTHFR gene mutation or struggle to break down and methylate their B-vitamins properly, a good B-vitamin support (I recommend this one), along with a high quality prenatal (find it here) are also helpful.

Hormonal issues are deeply connected to gut health, so it is always wise to take a good probiotic (I recommend this one for daily use)

Women attempting pregnancy can also improve egg quality by taking high quality co-q-10 (like this).

Women with severe blood sugar imbalances like type II diabetes can also consider a stronger blood sugar support protocol (this is one I recommend)

Finally, because the liver is also deeply involved in hormonal processes, liver support from milk thistle is also beneficial (I like this one)

There are several more that can help and which we would consider if working together one on one, but these, alongside a good multivitamin (I recommend this one), are a good start.

#3 Tracking Food intake

Since women with PCOS have insulin resistance and are often overweight or gain weight easily, there are problems with the way they experience hunger.  Namely, they experience more hunger than their body really needs.  This is especially true when any starches, sugars, or artificial sweeteners are present in the diet.

This is why I don’t recommend a mindfulness based eating approach in women with PCOS at first.

It is important for women to have an idea of what is the right amount of food, what that feels like, and to get used to it.  Also, it’s important to know if you are getting enough micronutrients, vitamins, and minerals, and maintaining the right levels of macronutrients (fats, carbs, and protein) according to your diet.

I love tracking apps like myfitnesspal and cronometer.com and I recommend that while trying to lose weight, you keep track of you food.

It may seem obsessive, but some obsession is required to lose weight with a condition like PCOS.

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Like it or not, losing weight with PCOS can be HARD and it requires work, dedication, and consistency.  But it IS possible.  Please don’t give up on yourself!

Remember that weight loss is a slow affair.  It took a while to gain the weight and it takes even longer to lose it.  Some women with PCOS see only an average of half a pound a week, while some lose more or less.  Keep track of the average over time and take progress pictures.  As you gain muscle, you may not see movement on the scale, but photos can tell a different story.

If you’ve tried all of that and are still having trouble, or just want some encouragement and specialized attention, working with a functional nutritionist who focuses on your unique situation can help.  

There are several phenotypes of PCOS and not everyone is the same.  Each individual will respond differently.  I can help with that!  I work in person in San Antonio or with distance clients.  Find out more here.