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Why am I not Losing Weight with PCOS?

There are many potential reasons why you may not be successful losing weight with PCOS. Some are easily fixed and some may require the help of a practitioner.  With confusing nutrition advice everywhere, it’s no wonder it’s so hard to do this alone.

I’ve chuckled to myself when clients tell me they’ve been doing everything “right”- eating complex carbs and drinking fat-burning coffee, going low-fat, exercising vigorously and sipping fruit smoothies- but still not seeing results.

There’s a lot of misinformation floating around. It’s not your fault, and the frustration is valid.

You need a thorough understanding of the basics of PCOS before you can understand weight loss for PCOS very easily, I cover those in this article on understanding PCOS.  If you haven’t been formally diagnosed, a self-assessment can also help give you more information. 

Is it possible to lose weight with PCOS?

Quick Takeaways

• Balanced macros beat calories alone

• Diet products often add unwanted calories

• Food sensitivities, alcohol, hidden sugars, artificial sweeteners will sabotage you

• Leptin resistance + exercise stress can deeply affect results

• Support systems are key to maintaining progress

Reason #1 Imbalance of nutrients

Having an imbalance of nutrients, particularly macro-nutrients (fat, protein, and carbohydrates) is one of the major reasons for issues losing weight. Structured dietary interventions greatly improve insulin sensitivity and body composition in PCOS and those include a key balance of macros.  [J Clin Endocrinol Metab. 2020. PMID: 32621748]

Many people assume that calories are all that matter.  We’ve always been taught that it’s about calories in and calories out.

I’m not the kind of diet peddler who will tell you that calories don’t matter.  They absolutely do.  They are the fundamental units of energy that we use.  BUT,  they aren’t all that matters.

Do calories matter for losing weight with pcos?

I can’t tell you how many clients I’ve seen that have consistently been consuming low-calorie diets that are made up of processed products like bars and snacks, shakes, and frozen dinners.  These diets tend to be heavy on the carbohydrates, low in fats and protein and filled with preservatives.  This is bad for weight loss.

Calories matter, but macros matter more, especially with PCOS.

To truly lose weight, both daily and meal-level macro balance matters. Start each meal with 20–35 g of protein, then add healthy fats and fibrous carbs. Tailor your carbs and fats to your unique response.

High-protein diets significantly improve insulin resistance and weight management in women with PCOS. [Nutrition & Diabetes. 2024. PMID: 38424054]

You can learn the best approach to losing weight with PCOS by following the best strategies for PCOS weight loss. 

Reasons you aren’t losing weight with PCOS #2 Consuming too many “diet” products

Food is food.  If you are eating a regular diet but trying some “keto” products to help with weight loss, all you are doing is consuming more food and sabotaging your efforts.  This principle goes both ways.

Can foods cause fat burning?

The bulletproof coffee trend is a perfect example of this.  When people describe a product as “fat burning” it is just marketing. No food is fat burning in and of itself.  Several foods can boost your metabolism, but only modestly and only in the context of a healthy diet that also accounts for the amount of food you’re consuming.

The key to consistent weight loss is eating real food in reasonable quantities and sticking to your program, whatever that may be.

Stay away from gimmicks and fat-burning supplements as they rarely do more than a slight bit to improve weight loss and can be damaging or harmful (many fat burners contain far too much caffeine, for example).  

The exception to this rule would be supplements for PCOS that help manage the metabolic issues that underpin the condition: things like insulin resistance or inflammation.  When you take supplements like n acetyl cysteine for your PCOS or even a high quality inositol blend, you are directly improving root cause issues in PCOS which can help “boost” your metabolism indirectly. 

You can learn about the root causes of PCOS symptoms and how to manage them and also how to plan an ideal diet for PCOS to really start making progress losing weight with PCOS.

Why am I not losing weight with PCOS # 3 Food Sensitivities

In my practice, I often see clients struggle with weight loss (and especially inches loss) when they consume foods they are sensitive to on a regular basis.  In my experience, one of the biggest offenders is dairy but it can also be grains, eggs, nuts, or even other foods.

When consumed, these foods cause an immune reaction that results in systemic inflammation that both bloats the body and causes it to hold on to weight.  Even where weight loss is still happening, I often see minimal inch loss because of this inflammation.  

Many people develop food sensitivity due to stress on the body or digestive system and discerning food sensitivity is a complex process.

In my opinion, food sensitivities slow weight loss because our bodies view fat as a survival mechanism.  When we have a severe food sensitivity or a food allergy, our bodies might think we are sick or in danger and may hold on to body fat as a primal means of survival.

Addressing food sensitivities with PCOS can help you make progress in losing weight with PCOS. 

Reasons you aren’t losing weight with PCOS #4 Too much alcohol

Alcohol, while perfectly fine in moderation, is not wise to consume during a weight loss diet, especially with PCOS.

When you’re doing everything else right and weight still isn’t budging, ask yourself if you’ve been having drinks here and there.

The body must process alcohol before it can get to the business of weight loss as both require the liver, our body’s natural detox organ.  A glass of wine every night is enough in some people to completely prevent progress, even if calories are appropriately managed.  Not only that, but drinking can cause water retention and puffiness that won’t make you feel great and might prevent you seeing progress. 

Added sugars and artificial sweeteners: Why am I not losing weight with PCOS #5

Did you realize that the tea you’re drinking might have sugar in it?  Or the dressing you’re using?  Many items which seem like no big deal, or which you don’t feel you are eating or drinking much of, can have a profound effect on weight loss when they contain added sugars.

This is because of a phenomenon called the compound effect.  When we seek to lose weight, we need to ensure we are in a deficit of calories, along with keeping balanced blood sugar.  When we eat in this deficit every day, we make progress.  But if we have a few days a week where we don’t meet this deficit, we may maintain or even gain weight, depending on how much we go over and how frequently.  

Many reduced or low fat products contain added sugars as well.

Sugar spikes insulin which is one of our fat storage hormones.  In many people, especially those with PCOS, managing insulin balance is more key for weight loss than calorie amount.  So, even if the item is low-ish in calories, spiking your blood sugar might be enough to slow your progress, especially if you are insulin resistant.

Are artificial sweeteners okay when losing weight with pcos?

Additionally, many people consume far too many products with artificial sweeteners during a diet.  These products may taste like the things you’re missing but they have many unfortunate side effects like gastrointestinal distress (which can contribute to inflammation and gut dysbiosis) as well as affecting the way you metabolize real sugar.

#6 Leptin Resistance: When Cravings Sabotage losing weight with PCOS 

A lot of people don’t know about a hunger hormone called Leptin. 

Leptin is a hormone that signals to our body when we are full.  In a normal metabolism, we would eat and then feel full after an appropriate amount of food to maintain our body.  

In PCOS, leptin resistance often occurs alongside insulin resistance. 

While insulin resistance makes it so that we store more fat when our blood sugar spikes, leptin resistance makes it difficult for us to intuitively tell when we are full or still hungry. 

This can lead to unintentional overeating if you are relying only on your body’s hunger cues for information about how much to eat.  In PCOS weight loss, there often needs to be other strategies to help us overcome leptin resistance- things like tracking our protein and fiber intakes, slowing down our meals and even sometimes counting out the macros of our food.   Here’s more detail on that:

Intuitive Eating: The PCOS Struggle

Reasons you aren’t losing weight with PCOS: #7 You’re Sedentary or too active

There is a profound human need for movement.  From studies showing it increases life span and health, to happiness, bone density, and lowered risk of chronic disease, we know that getting up and getting moving is important for our well-being.

But moving daily also has a boosting effect on weight loss. 

Yes, it is possible to lose weight without exercise and many people who are encumbered by injury or body weight must start this way.  However, regular exercise should be incorporated as soon as possible and especially when close to goal weight, exercise becomes a vital component to the weight loss journey. 

On the other hand, some of us put too much focus on exercise, believing we can burn off extra calories without having to alter our diets.  While adding extra exercise can be helpful, excessive exercise is not the answer and may actually place the body under too much stress.

We need rest and recovery in order to repair our muscles so be sure you are incorporating rest days into your routine.

Why am I not losing weight with PCOS #8: Lack of support

Perhaps more important than anything, support is that vital missing component in many people’s weight loss journey.

Without a supportive friend, accountability partner, or nutritionist the studies show that you may be more likely to give up. 

Try to find a friend, join a subreddit, or find a community of others interested in working on weight loss.

Even if your family is unsupportive, you can’t find a friend who’s willing to commit, and you feel all alone, you can use the resources of a good nutritionist and her staff to give you that accountability, support, and advice you need to stay motivated.

For more help with your PCOS, including tackling weight loss from a holistic perspective, functional nutrition PCOS courses can give you greater depth on the topics you’re struggling with. 

The best PCOS diet combines a balanced approach to meal planning, root cause targeted solutions and simple strategies that can be stuck to over the long haul like the ones I discuss in PCOS Foundations. 

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