Why Women with PCOS Struggle to Lose Weight (And How to Fix It)
- Evgeniya Zhukovskaya
- 15 minutes ago
- 8 min read
PCOS affects about 20% of women worldwide. This makes losing weight with PCOS one of the biggest challenges for millions of women.
You're not alone in this struggle, especially when you have to deal with overwhelming and conflicting advice online. "PCOS diet" content has generated over 470 million views on TikTok alone.
Weight gain and PCOS share a complicated relationship. All but one of these women with this condition deal with insulin resistance, which makes traditional weight loss methods nowhere near as effective. But there's good news - dropping just 5% of your body weight can dramatically improve PCOS symptoms.
The PCOS-Weight Connection: Understanding Why Weight Gain Happens
Weight gain with PCOS isn't just about eating too much or not exercising enough. Your body works against you because of complex hormonal imbalances that change how your metabolism works.
How insulin resistance drives PCOS weight gain
Between 38% and 88% of people with PCOS are overweight or obese. PCOS changes how your body uses insulin. Your cells become resistant to insulin signals, which makes your pancreas produce more insulin to make up for it. This resistance to insulin affects 50%-90% of women with PCOS 22.
Extra insulin does more than affect blood sugar - it makes your body store fat, mostly around your middle area. High insulin levels make your ovaries produce more androgens, which creates an ongoing cycle 3. Your body also has trouble controlling hunger because insulin resistance disrupts hormones like ghrelin, cholecystokinin, and leptin 1.
Your body fights against weight loss at a biochemical level.
This helps explain why you feel hungry all the time even when you try to control your appetite.
The role of male hormones in fat distribution
PCOS changes how much weight you gain and where you store it. High levels of androgens create an "android" fat pattern - your body stores fat mainly in your abdomen instead of your hips and thighs 23. Women with PCOS often have an "apple shape", unlike the "pear shape" that's common in women without PCOS.
Fat around the abdomen can be dangerous because it increases your risk of heart disease and other health issues. Research shows that women with PCOS have much more upper-body fat compared to lower-body fat 24. Scientists have found a strong link between upper-body fat and androgens like testosterone and DHEA-S.
Why traditional diets often fail for women with PCOS
Regular calorie-restricted diets rarely help anyone keep weight off long-term. These diets work even less for women with PCOS 6. Women with PCOS tend to have slower metabolisms than others 7.
Women with PCOS might only lose weight by severely restricting calories. This approach fails because it slows down metabolism even more. The weight comes back quickly when normal eating resumes - usually with extra pounds 7.
Studies show that up to 60% of women with PCOS participate in binge eating behaviours.
Your hormonal imbalances make it hard to regulate appetite with PCOS. The hormones that control hunger and fullness don't work properly. This makes it almost impossible to stick to restrictive diets. Strict dieting can lead to obsessing over food and disordered eating patterns.
How PCOS Changes Your Metabolism
PCOS does more than affect how many calories you burn - it changes your entire metabolic system. Women with this condition face unique challenges that make managing weight harder than usual.
The science behind slower metabolic rates in PCOS
Research shows that PCOS lowers women's basal metabolic rates (BMR) compared to those without this condition. Studies found that the adjusted BMR was 1,868 kcal/day in healthy women while women with PCOS had just 1,445 kcal/day. This big difference stays constant even after adjusting for age and BMI.
The slowdown gets worse when women have both PCOS and insulin resistance. Their adjusted BMR drops to only 1,116 kcal/day - 40% lower than women without PCOS 8. This explains why you might gain weight even when eating the same amount as your friends who don't have PCOS.
Several factors create this metabolic challenge. Women with PCOS tend to have lower lean body mass and skeletal muscle mass. These elements determine how many calories your body burns while resting.
Why calorie counting alone doesn't work
Standard calorie-based diets don't address PCOS's hormonal imbalances. Women with PCOS often need to cut calories drastically to see results. This approach backfires and slows metabolism even more.
Counting calories can make you skip foods that help balance hormones. Many women avoid healthy fats like avocados or nuts because of their high calorie content.
Healthy fats help stabilise blood sugar and lower insulin levels.
The quality of your diet matters more than counting calories for metabolic health. A six-month study showed that women with PCOS lost more weight on a higher protein diet compared to standard calorie restriction 1. This suggests that balancing nutrients works better than focusing on calorie numbers.
Effective Diet Strategies for PCOS Weight Loss
PCOS diet management needs a targeted approach based on your hormonal profile. Your diet strategy should target insulin resistance and inflammation - these mechanisms cause stubborn weight gain.
Low glycemic eating to manage insulin levels
Research shows 35% to 80% of people with PCOS have insulin resistance. Your body may benefit from low glycemic index (GI) foods. These foods digest slowly and create gradual blood sugar rises instead of sharp spikes that make insulin resistance worse 12.
Low GI diets help improve insulin sensitivity, regulate menstrual cycles, and support weight loss. Your diet should include whole grains, legumes, non-starchy vegetables, and most fruits. Limit consumption of refined carbohydrates like white bread, sugary cereals, and processed snacks that cause insulin spikes 13.
Anti-inflammatory foods that curb PCOS symptoms
Chronic inflammation makes PCOS symptoms worse. Anti-inflammatory foods can improve your condition. Add colourful berries, cherries, leafy greens, cruciferous vegetables, and omega-3 rich fatty fish to your diet 4. Turmeric, ginger, and cinnamon stand out with their powerful anti-inflammatory properties. Healthy fats from avocados, olive oil, nuts, and seeds help balance your hormones and reduce inflammation 13.
Meal timing strategies to regulate hormones
Your meal timing plays a crucial role in managing PCOS. Research shows that women with PCOS who ate their biggest meal at breakfast saw a 54% decrease in insulin resistance. Their free testosterone levels dropped by 50% compared to those who ate their largest meal at dinner.
Your blood sugar stays stable when you eat every 3-5 hours during the day 2. Match your meals with your body's natural rhythm - eat within 1-2 hours after waking up and finish your last meal 2-3 hours before bed. This helps regulate your hormones better.
Sample PCOS diet plan for a week
Breakfast: Protein-packed meals with eggs or Greek yoghurt plus low GI carbs like oats and berries
Lunch: Lean protein with plenty of vegetables and some whole grains
Dinner: Anti-inflammatory proteins such as fatty fish or tofu paired with non-starchy vegetables
Snacks: Nuts, seeds, or low-glycemic fruits between main meals
Each meal should have 25-30 grams of protein, plenty of fibre (about 30g daily), and healthy fats.
Exercise Approaches That Work With PCOS, Not Against It
Exercise is a vital part of managing PCOS, but not all workouts deliver the same results. Research shows 65-70% of people with PCOS have insulin resistance. The right exercise strategy can be a powerful tool to balance hormones.
Strength training to improve insulin sensitivity
Women with PCOS get remarkable benefits from resistance training to balance their hormones. Studies show that strength training reduces Free Androgen Index (testosterone levels) better than other types of exercise 16.
Your metabolic rate goes up when you build muscle through strength training.
This helps counteract the potentially slower metabolism that comes with PCOS. Better skeletal muscle function helps your body use energy more efficiently throughout the day. This can help fight stubborn weight gain.
The right cardio approach for hormonal balance
Cardio needs a balanced approach - too little won't help, while too much could make symptoms worse. Research points to vigorous aerobic exercise improving insulin measures when done correctly.
High-intensity interval training (HIIT) shows great promise. It helps reduce both insulin resistance and excess testosterone 16. Nevertheless, cardio sessions should stay under 60 minutes to avoid excess cortisol production, which can make PCOS symptoms worse.
The best approach has about 30 minutes of moderate-to-vigorous physical activity daily, five days each week 20. A mix of cardio and strength training provides optimal results.
Stress-reducing movement for cortisol management
PCOS symptoms get worse with stress, so mind-body practices are a great way to get benefits. Yoga, Pilates, and tai chi lower cortisol levels while providing physical benefits 5.
These practices work especially well when you have higher rates of anxiety and depression, common in women with PCOS 21. Controlled breathing techniques during a yoga practice help reduce stress and promote hormonal balance 5. They can perfectly complement more intense workouts.
You get better results from being consistent rather than perfect.
The most effective exercise plan is one you'll stick with - whether you choose walking, cycling, dancing, or structured workouts. Finding movement you enjoy helps you create habits that work with your PCOS, not against it.
Conclusion
PCOS creates special challenges for weight management. Your body's hormonal patterns don't have to be obstacles - they can guide your lifestyle choices to create lasting results. A combination of low glycemic eating and smart meal timing helps control insulin levels. The right mix of strength training and cardio improves hormone balance without stress that could make symptoms worse.
PCOS weight management needs a long-term approach instead of quick fixes. Small diet and exercise changes add up to create real improvements over time.
Want a customised PCOS management plan? Book a free 30-minute call to learn about sustainable ways to reach your health goals while working with your body's natural patterns.
FAQs
Q1. Is it possible to be slim with PCOS?
Yes, it is possible to be slim with PCOS. While many women with PCOS struggle with weight gain, about 20-30% of women with the condition maintain a healthy weight or are lean. However, achieving and maintaining a healthy weight often requires a tailored approach to diet and exercise that addresses the hormonal imbalances associated with PCOS.
Q2. What are the most effective strategies for weight loss with PCOS?
The most effective strategies for weight loss with PCOS include following a low glycemic diet, incorporating strength training and moderate cardio exercise, managing stress levels, and focusing on protein-rich foods. These approaches help manage insulin resistance, balance hormones, and boost metabolism, which are key factors in PCOS-related weight gain.
Q3. How can I tell if my PCOS symptoms are worsening?
Signs that your PCOS may be worsening include increasingly irregular periods, worsening acne or oily skin, increased hair growth in typically male areas (hirsutism), accelerated weight gain especially around the abdomen, thinning hair on the scalp, and difficulty conceiving. If you notice these symptoms intensifying, it's important to consult with your healthcare provider.
Q4. Why is losing belly fat particularly challenging for women with PCOS?
Losing belly fat is especially challenging for women with PCOS due to hormonal imbalances. High levels of insulin and androgens (male hormones) promote fat storage around the midsection. Additionally, PCOS affects appetite-regulating hormones, making it harder to control hunger and cravings. These factors combined make abdominal weight loss more difficult but not impossible with the right approach.
Q5. How does PCOS affect metabolism and weight loss efforts?
PCOS significantly impacts metabolism, often resulting in a slower basal metabolic rate. Women with PCOS may burn fewer calories at rest compared to those without the condition, even at the same weight and age. This metabolic disadvantage, combined with insulin resistance, makes traditional calorie-counting approaches less effective. Successful weight loss typically requires strategies that specifically address these hormonal and metabolic challenges.
References
Kommentarer