PCOS belly and weight gain are two of the most common PCOS symptoms that I’m asked about as a registered dietitian. And for good reason too, since losing weight can often seem impossible when you have PCOS.
This blog post will discuss what PCOS belly is and what causes it. Then we’ll dive into some realistic and sustainable tips on how to get rid of PCOS belly.
What Is PCOS Belly?
Polycystic ovarian syndrome (PCOS) is a common hormonal disorder that affects approximately 6-12% of women of reproductive age. This condition is associated with insulin resistance, chronic inflammation, and high androgen levels (aka male hormones such as testosterone).
Some common symptoms of PCOS are irregular periods, weight gain, higher body mass index (BMI), carb cravings, hair loss, hirsutism (aka excessive hair growth – particularly body and facial hair), acne, and fatigue.
When someone with PCOS experiences weight gain, it may seem to be primarily abdominal fat accumulation. Many people will often describe that their belly, or abdominal area, holds the majority of their weight, while other areas of the body seemingly remain the same. This can give the appearance of an apple body shape and is frequently termed PCOS belly.
In reality, this isn’t a true medical term recognized in the medical community. Therefore there isn’t an established definition of what qualifies as a PCOS belly shape or even the typical PCOS body shape for that matter.
According to a recent systematic review, women with PCOS have more abdominal subcutaneous fat compared to BMI-matched healthy controls. Subcutaneous fat is the fat that accumulates under the skin. This type of fat usually feels soft and squishy when you push against it.
That same meta-analysis found mixed results for whether women with PCOS have higher amounts of visceral fat compared to healthy controls. Visceral fat is the type of fat that’s located deeper in the abdominal cavity. It surrounds the body’s organs and is considered to be a more dangerous type of fat compared to subcutaneous fat.
It is important to note that PCOS weight gain is a very common symptom and can be happening for several reasons. Let’s dive into a few typical reasons for abdominal weight gain.
What Causes It?
There are several potential causes of abdominal weight gain. Chronic inflammation and other hormonal imbalances, such as insulin resistance or elevated cortisol levels, may be to blame for PCOS belly.
Up to 80% of women with PCOS have some degree of insulin resistance (1). Insulin is a hormone that is responsible for regulating blood sugar levels. When someone is insulin resistant, the body doesn’t effectively move glucose from the bloodstream into the cells. This leads to high insulin levels. The hormone insulin is commonly known as a “fat storing” hormone, so high levels of insulin can lead to increased fat accumulation, particularly in the abdominal area (2).
Chronic inflammation is also at the core of the pathophysiology of PCOS. Inflammation worsens insulin resistance, which can lead to weight gain. Research has also shown that inflammation gets worse with weight gain. Additionally, weight gain can make insulin resistance worse, which only further perpetuates this vicious cycle.
Cortisol levels are often higher in those with PCOS (3, 4). Cortisol is commonly referred to as our “stress hormone”. High levels of cortisol increases blood sugar levels and insulin resistance, which can lead to weight gain.
Additionally, bloating is another common complaint when it comes to PCOS. Some people will refer to this as PCOS belly bloat. If you find that your belly changes based on what you eat, or that your belly isn’t bloated in the morning then gets larger as the day goes on, you’re probably experiencing bloating rather than a true PCOS belly.
For the full scoop on PCOS bloating check out this post: PCOS Bloating: What Causes It & 7 Tips To Get Relief.
What Are The Risks of Having a PCOS Belly?
Unfortunately, there are risks that come with having a PCOS belly, or increased abdominal fat. PCOS women are at a higher risk for developing type 2 diabetes, gestational diabetes in pregnancy, high blood pressure, high cholesterol, fatty liver, and heart disease.
The good news is that you can take steps to reduce your PCOS belly and lower your risk of developing other health conditions. Let’s talk about those now!
How to Get Rid of PCOS Belly
The best ways to reduce your PCOS belly are to target the root causes through dietary changes and a healthy lifestyle. This means a balanced diet and lifestyle modifications that target insulin resistance, inflammation, and high cortisol levels.
A healthy PCOS diet can make a big impact on your blood sugar levels and improve insulin sensitivity. Additionally, including anti-inflammatory foods can help lower inflammation levels considerably.
Eat More Fiber
Most people aren’t getting enough fiber in their diet, and women with PCOS are no exception. Fiber is a type of carbohydrate that is slowly digested and can prevent your blood sugar levels from rising too quickly. It’s also going to keep you feeling more full, which can lead to eating less calories overall.
Prioritize Protein At Meals
Protein is such an important macronutrient for several reasons. Protein helps to keep blood sugar levels more balanced, which can lower insulin resistance.
Protein can also keep you feeling full for longer periods of time. Studies show that protein can actually decrease ghrelin, our hunger hormone; while increasing peptide YY, a hormone that reduces appetite (5, 6).
Most people feel their best when they include at least 20 grams of protein per meal. Good sources of protein include poultry, lean red meat, seafood, Greek yogurt, cottage cheese, eggs, tofu, tempeh, edamame, beans, lentils, and quinoa. Protein powders can also be a good way to increase your protein intake.
Check out this post: The Best Protein Powders For PCOS (And Which To Avoid).
Include Healthy Fats
This may seem counterproductive if you’re trying to reduce PCOS belly fat, but healthy fats are an important part of a healthy diet. Fat is necessary for hormone production, the absorption of certain vitamins, and for satiety.
Healthy fats, particularly monounsaturated fats and polyunsaturated fats, can lower inflammation levels. Good sources of healthy fats include olive oil, avocado, fatty fish, nuts, and seeds. Include a source of these fats at each meal.
Fatty fish like salmon, chia seeds, flaxseed, hemp hearts, pumpkin seeds, and walnuts are great sources of omega 3 fatty acids. These types of fat sources are especially beneficial for lowering inflammation in PCOS (7).
Eat More Anti-Inflammatory Foods
Anti-inflammatory foods can also be potent for lowering inflammation. Fruits, vegetables, whole grains, beans, legumes, nuts, and seeds are all considered anti-inflammatory. Some specific foods can have more anti-inflammatory properties than others such as broccoli, berries, spinach, fatty fish, olive oil, green tea, and matcha.
For a full list of specific anti-inflammatory foods, grab your free copy: Anti-Inflammatory Foods List PDF.
Increase Your Probiotics
The gut microbiome plays a big role in our overall health. To diversify and optimize your gut microbiome, you’ll want to include more healthy probiotics into your diet. Fermented foods such as Greek yogurt, cottage cheese, kefir, sauerkraut, kombucha, tempeh, and kimchi are great options for this.
Check out these recipes for ways to effortlessly include more probiotics in your diet:
- High Protein Cottage Cheese Smoothie: this one tastes like a healthy strawberry cheesecake!
- Mango Kefir Smoothie: if you’ve never tried kefir before, this is a great way to use it for the first time!
For more info on how to actually put diet changes into practice, check out A Dietitian’s 7 Day PCOS Diet Plan (PDF Included).
There’s a lot of debate about what the best exercises are for PCOS. The reality is that there are various benefits to all types of exercise. The fact that you’re incorporating regular exercise into your routine is usually the most important part.
Strength training and building lean muscle mass can increase insulin sensitivity. Aerobic exercise such as high-intensity interval training (HIIT) or cardio is great for reducing blood glucose levels and the risk of cardiovascular disease. Yoga and walking are great ways to reduce stress, cortisol, and testosterone levels.
Getting enough sleep each night can seem difficult but it’s incredibly important for hormone health. Poor sleep can increase insulin levels and alter our hunger hormones, leading to overeating, increased body fat and weight gain.
Chronic stress can really wreak havoc on our body. High stress levels can increase cortisol levels (aka our stress hormone). This can then increase blood sugar levels, which can worsen insulin resistance and inflammation.
Take some time to incorporate some self care practices into your regular routine. This may look like regular exercise, meditation, a relaxing bath, journaling, or a good book.
How can I get rid of my PCOS belly?
PCOS belly is an accumulation of adipose tissue in the abdominal area. It can be caused by a variety of factors including insulin resistance, inflammation, and high cortisol levels. Eating a balanced diet that includes fruits, vegetables, whole grains, beans, nuts, seeds, and lean protein sources can target the root cause of the weight gain. Additionally, regular exercise, adequate sleep, and stress management can help to reduce PCOS belly and promote weight loss.
What does PCOS belly look like?
There isn’t one particular look for PCOS belly. It can look different on different people. It typically includes fat distribution predominantly in the lower abdomen, with the rest of the body seemingly unaffected or less affected. Many people describe this as a classic apple body shape.
Is PCOS belly soft or hard?
PCOS belly is soft. It’s an accumulation of subcutaneous fat in the belly area, which is soft and squishy.
The Bottom Line
PCOS belly is not a medically recognized term, however, it commonly refers to the typical PCOS related weight gain pattern. PCOS belly is an excess fat accumulation in the abdominal region.
It can be caused by several different factors such as insulin resistance, inflammation, and high cortisol levels. Unfortunately, PCOS belly does put you at an increased risk of developing other chronic health conditions such as type 2 diabetes and cardiovascular disease.
Diet and lifestyle changes that lower insulin resistance and inflammation can help you lose weight and reduce PCOS belly.
Disclaimer: this is not intended to substitute for or replace routine medical advice for polycystic ovary syndrome (PCOS) or any other health condition. Always consult with your healthcare provider for personalized recommendations.