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Hi, I’m Alyssa! AKA, The PCOS Nutritionist Alyssa!

I’m a Registered Dietitian dedicated to helping you eliminate your PCOS symptoms with sustainable and realistic nutrition changes.

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How To Lose Weight With PCOS: 10 Tips From A Dietitian

How to lose weight fast with PCOS? That seems like the most popular question I’m asked as a registered dietitian that specializes in PCOS. 

Having PCOS can sometimes make weight gain happen quickly and make weight loss seem impossible. Rest assured though, it’s not impossible to lose weight with PCOS…you’ll just need to understand how to lose weight with PCOS effectively.

This blog post will discuss why weight loss is so hard with PCOS. Then we’ll dive into steps you can take that will help you to lose weight with PCOS. 

photo of dumbbells, an apple, tape measure, and oatmeal. Text overlay states how to lose weight with pcos.

What Is PCOS?

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that affects approximately 6-12% of women of reproductive age in the United States and up to 20% of women worldwide. This condition can present in a myriad of ways, but common symptoms of PCOS include irregular periods, weight gain, food cravings, hair loss, hirsutism (excess facial or body hair growth), acne, fatigue, mood swings, and infertility.

The exact cause isn’t well understood but PCOS is associated with insulin resistance, chronic inflammation, and high levels of androgens (aka male hormones like testosterone). 

Because of this, women with PCOS are at a higher risk of developing other chronic diseases such as type 2 diabetes, gestational diabetes in pregnancy, high blood pressure, metabolic syndrome, heart disease, endometrial cancer, and fatty liver.

While that may sound scary, I believe knowledge is power and there are definitely steps you can take to lower your risk of diabetes and other health conditions. Before we talk about those steps, let’s discuss why weight gain happens and why PCOS weight loss seems so elusive. 

Why Does PCOS Cause Weight Gain? 

There are several reasons why weight gain can happen, but it usually comes down to hormonal imbalances that are common in PCOS. 

Some common reasons for PCOS weight gain are:

  • Insulin resistance occurs in up to 80% of those with PCOS (1). Insulin is a hormone that’s responsible for moving glucose (aka your blood sugar) into the cells to be used for energy. With insulin resistance, your body is resistant to insulin…this leads to too much insulin being released to be able to get the job done. High levels of insulin can lead to belly fat storage. 
  • Inflammation is a core piece of PCOS pathogenesis (2). Acute inflammation when you’re sick is a good thing, but chronic inflammation is what we see with PCOS. It’s a vicious cycle too since inflammation can worsen insulin resistance and lead to weight gain, but excess weight can increase inflammation.
  • High cortisol levels can commonly happen in PCOS also (3, 4). Cortisol is another hormone, commonly referred to as our “stress hormone”. When cortisol levels are high, it can increase blood sugar levels and worsen insulin sensitivity, which can ultimately lead to weight gain.
  • Other hormonal imbalances may also be at play such as thyroid dysfunction, or estrogen and progesterone imbalances. 

For more info on what causes PCOS weight gain, check out this post: What Is PCOS Belly? A Dietitian’s 8 Tips To Reduce It.

infographic on what factors cause pcos weight gain.

How To Lose Weight With PCOS Fast

If you’re feeling depressed about your weight, I want to reassure you that it is possible to lose weight with PCOS. Unfortunately, there’s no magic fix to lose weight fast with PCOS though.

There currently is no cure for PCOS so losing weight with PCOS requires long-term diet and lifestyle changes. That’s why I recommend a balanced diet approach to effectively and sustainably achieve a healthy weight. It may not happen immediately, but usually if weight comes off quickly, it goes back on quickly…which obviously isn’t what you want!

Ultimately, you’ll want to target the root cause of why you’re gaining weight in the first place. That usually means trying to lower inflammation, balance blood sugar levels to reduce insulin resistance, and reduce stress. You can target these through diet, lifestyle changes, and sometimes even medication and supplements. Let’s dive into how your diet can help you lose weight.   

Best PCOS Diet To Lose Weight

There is no single best diet identified for PCOS at this point. Ultimately, you want a diet plan that’s sustainable though – because yo-yo dieting will only lead to weight cycling, where you’re constantly either in a state of losing weight or gaining weight.

You can read more about my thoughts on intermittent fasting for PCOS, or gluten-free diets, and dairy-free diets. But the short of it: research doesn’t support any of these diet approaches for everyone with PCOS…and no, you also don’t need to avoid carbs like the plague either!

I’m much more into the mindset of “what can I add more of” versus “what do I need to avoid” when it comes to a healthy PCOS diet. That’s because I’ve worked with hundreds of women with PCOS who have also seen success using this approach (and don’t forget that I have PCOS too!). Let’s talk about some key components you’ll want to include in your diet. 

But first, grab a full PCOS Grocery List here!

Increase Fiber Intake

While some people will claim that you need to eat a low-carb diet for PCOS, this isn’t true at all. Instead of avoiding carbs, you’ll want to be smart and choose complex carbohydrates. These types of carbs are high in fiber and have a lower glycemic index – meaning they won’t cause blood sugar spikes like other types of carbohydrates would. 

Fiber is a type of carbohydrate that gets slowly digested and absorbed in the body. It causes your blood sugar levels to rise much more slowly and helps improve insulin sensitivity. It’s also very beneficial for improving gut health and lowering your risk of cardiovascular disease. 

Some good sources of fiber for PCOS include:

  • Fruits
  • Vegetables 
  • Whole grains (whole grain bread, brown rice, quinoa, oats, whole grain pasta, farro, etc)
  • Beans & other legumes (chickpeas, black beans, pinto beans, peas, lentils, soybeans)   

Although some people may vary, a good rule of thumb is to aim for 25-30 grams of fiber per day. 

Get Enough Protein

Protein is definitely having its moment right now, and for good reason! It’s incredibly important for blood sugar balance and building lean muscle mass. 

Protein can also keep you feeling full for longer too by decreasing ghrelin, our hunger hormone; and increasing peptide YY, a hormone that reduces appetite (5, 6). One study showed that women who increased their protein intake from 15% to 30% of their total calories actually ate 441 less calories per day and lost about 10 lbs on average (7).

How many grams of protein you’ll need will be dependent on you and your needs. Emphasize lean proteins when possible for the majority of your protein intake. Good lean protein sources include chicken, turkey, lean red meat (beef, pork), fish, seafood, tofu tempeh, edamame.

Include Healthy Fats

While fat was demonized in the past, fat is necessary for hormone production, satiety, and the absorption of certain vitamins. Try to include more healthy fats in your day, which are going to be higher in monounsaturated and polyunsaturated fats. 

Some good sources of healthy fats are olive oil, avocado, nuts, and seeds. 

Add Anti-Inflammatory Foods To Your Day

We talked about how inflammation plays a role in PCOS and weight gain. It’s only natural that you’ll want to include more anti-inflammatory foods into your diet to help reduce inflammation. 

Some anti-inflammatory foods are berries, apples, bananas, kiwis, cherries, sweet potatoes, tomatoes, bell peppers, corn, dark leafy greens like spinach and kale, salmon, olive oil, chia seeds, flaxseed, and walnuts. 

Experiment With Fermented Foods

Since women with PCOS tend to have subpar gut health, including fermented foods is a good idea. Fermented foods are great sources of probiotics, the healthy gut bacteria we need for better gut health and overall health. 

Some good options include Greek yogurt, cottage cheese, kefir, tempeh, sauerkraut, kimchi, and kombucha.

Consider Beneficial Spices or Beverages

Yes, you read that correctly. Certain drinks or spices we add to our food can have anti-inflammatory or anti-diabetic properties.

If you enjoy these types of food, they can be beneficial to include more frequently: cinnamon, garlic, ginger, turmeric, and teas including matcha, green tea, and spearmint tea.   

For some ideas on how to actually pull this all together into your daily routine, check out A Dietitian’s 7 Day PCOS Diet Plan (PDF Included).

Ok, now let’s talk about some lifestyle changes that can really help with weight loss. 

infographic on how to lose weight with pcos.

Physical Activity

Incorporating regular exercise is crucial for improving your overall health…and this has nothing to do with that old and outdated mantra of “calories in versus calories out”.

Moving your body, whether it’s an intense sweat session or a leisurely walk around the block, can have a positive impact on your PCOS symptoms. Physical activity can lower blood sugar, testosterone levels, cortisol levels, and anxiety. It can also improve focus and energy levels.

There’s no one type of exercise that is superior for everyone with PCOS either. I’d recommend choosing forms of exercise that you enjoy and can do consistently.

Sleep

Women with PCOS often struggle with sleep disorders such as obstructive sleep apnea or insomnia. These also don’t even account for the fact that we lead such busy lives that most adults aren’t even giving themselves the chance to get the minimum recommended amount of sleep.  

If you struggle with sleep, consider taking steps to improve your sleep hygiene by having more of a sleep routine. Also, consider talking to your doctor about a possible sleep study if you suspect you may have sleep apnea.

Stress

I briefly mentioned how cortisol is our stress hormone and cortisol levels are higher in those with PCOS. Managing stress is imperative when it comes to balancing hormone levels. 

Stress can be in the form that we typically perceive it: feeling overwhelmed. It can also be in the form of anxiety, poor sleep, or not eating enough. 

Implementing some self-care practices can really make a big difference in your health. This probably looks different for everyone but some examples may be meditation, journaling, deep breathing exercises, yoga, walking, reading, knitting, an at-home face mask or skincare routine. 

Medications

Medications such as Metformin, Mounjaro, or GLP-1 receptor agonist drugs like Ozempic may be beneficial. Your healthcare provider can discuss the pros and cons of these types of medications and whether they’re a good fit for you. 

Supplements

Dietary supplements are extremely popular in the PCOS community. Supplements can be a great addition to your treatment plan if they’re the right fit for you. It’s important to note though that medications and supplements cannot replace a healthy diet or lifestyle modifications; they can merely supplement your efforts. 

Some PCOS supplements for weight loss:

Of course, this is not an exhaustive list of supplements that can assist with weight loss. Always be sure to consult with your healthcare provider about whether any supplements may be helpful for you.

FAQs: 

How can a PCOS patient lose weight fast?

Unfortunately, if you want PCOS weight loss that will last, there aren’t any quick fixes. The best way to achieve modest weight loss is to create sustainable diet and lifestyle habits that target the underlying hormone imbalances, such as high insulin levels. 

Why is losing weight with PCOS so hard?

PCOS is a hormonal disorder that is linked to other conditions such as insulin resistance, chronic inflammation, and high cortisol levels. All of these can make weight loss more difficult.

What does PCOS belly look like?

PCOS belly is not a medically recognized term, but it typically refers to the abdominal fat and weight gain seen in PCOS. There is not a specific look for PCOS belly though since it can look a little bit different in different people. Most people tend to describe it as an apple shaped body, where they gain weight in the abdomen, while the rest of their body doesn’t gain weight. 

The Bottom Line

Weight management can be one of the most difficult PCOS symptoms to manage. It’s usually because of underlying hormone imbalances, such as insulin resistance, high cortisol levels, or chronic inflammation. For most people, there isn’t a fast way to lose weight with PCOS and be able to keep the weight off for good. Implementing realistic and sustainable habits will help promote weight loss. 

Include foods in your PCOS diet that can reduce insulin resistance and inflammation. Additionally, lifestyle modifications such as regular exercise, adequate sleep, and stress management are beneficial for long term weight loss. 

In combination with dietary changes and lifestyle modifications, medications or supplements may be beneficial for some people. 

Disclaimer: this is for educational purposes only. It is not intended to substitute for or replace medical advice for the treatment of polycystic ovary syndrome (PCOS) or any other medical condition. Consult with your healthcare provider for personalized recommendations.

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