Many women with PCOS find that despite eating well and exercising, the weight doesn’t budge, and it’s incredibly frustrating. PCOS affects weight in multiple ways, from hormones to metabolism, but understanding why it’s harder can help you take back control.
1. Insulin Resistance, Leptin and Ghrelin
Insulin resistance is common in women with PCOS, leading to higher insulin levels in the blood. Higher insulin levels can promote fat storage, particularly around the abdomen, and can reduce the body’s ability to burn fat for energy. This can contribute to a lower Basal Metabolic Rate (BMR), which is the number of calories the body needs each day at rest, which in-turn reduces the number of calories you can consume each day before you put start to put on weight.
(BMR is the amount of energy, measured in calories, that your body requires to maintain basic physiological functions such as breathing, circulating blood, regulating body temperature, cell production, nutrient processing, and maintaining brain and nerve function. Essentially, BMR represents the number of calories your body needs to perform these essential activities without any additional physical activity.)
Insulin resistance can also interfere with leptin, a hormone that signals fullness. When leptin signalling is impaired, the brain may not receive accurate signals that the body has enough energy stored, leading to increased hunger. Elevated insulin levels may also raise ghrelin – the hunger hormone – making it harder to feel full and easier to overeat, even on a calorie-controlled plan.
2. Hormonal Imbalances
PCOS is associated with an imbalance of reproductive hormones, including elevated levels of androgens (male hormones) and lower levels of progesterone. These hormonal imbalances can affect the way the body metabolises food and stores fat. High androgen levels are linked to increased abdominal fat, which is metabolically less active compared to lean muscle mass.
3. Reduced Muscle Mass
Women with PCOS may have a tendency towards reduced muscle mass quite often due to lifestyle factors associated with PCOS, such as lower physical activity levels. Muscle tissue burns more calories at rest than fat tissue, so a lower muscle mass can contribute to a slower metabolism.
4. Thyroid Dysfunction
There is a higher prevalence of thyroid disorders, particularly hypothyroidism, among women with PCOS. Hypothyroidism can slow down your metabolism, making weight management more challenging. Only a doctor can advise if you have a thyroid disorder or not.
Addressing Metabolic Slowing in PCOS
1. Exercise
Regular physical activity is a cornerstone of weight management and can be particularly impactful for improving insulin sensitivity and building muscle mass.
- Strength Training is Key: Muscle tissue is metabolically active, meaning it burns more calories at rest than fat tissue. Building and maintaining muscle mass through strength training can help to increase your resting metabolic rate. Aim for 2-3 sessions per week, focusing on compound movements that work multiple major muscle groups. Examples include squats, lunges, push-ups, rows, and deadlifts. You can start with bodyweight and gradually add resistance as you get stronger.
- Incorporate Cardiovascular Exercise: Cardio is excellent for heart health, calorie expenditure, and can also improve insulin sensitivity. Aim for 150 minutes of moderate-intensity cardio (like brisk walking, cycling, or swimming) per week, or shorter bursts of higher intensity.
Consistency is more important than intensity when you’re just starting. Even short, focused workouts can make a significant difference over time.”
2. Diet
A balanced diet is key for managing weight and supporting overall metabolic health, which can be particularly challenging with PCOS. Focus on:
- Prioritising Fibre: Fibre-rich foods help regulate blood sugar levels, promote satiety, and support gut health. Think: whole grains (like oats, quinoa, brown rice), legumes (lentils, chickpeas), and plenty of non-starchy vegetables (broccoli, leafy greens, peppers).
- Choosing Low-Glycemic Index (GI) Foods: These foods cause a slower, more gradual rise in blood sugar, which can help manage insulin levels. Examples include most vegetables, fruits like berries and apples, lean proteins, and healthy fats.
- Lean Proteins & Healthy Fats: These are crucial for satiety and supporting overall health. Good sources include chicken breast, fish, eggs, tofu, nuts, seeds, and avocados.
Eating smaller, more frequent meals may also help maintain steady blood sugar levels and reduce hunger pangs for some individuals. Drinking plenty of water throughout the day can help reduce hunger and prevent overeating.
Important Note: While these dietary strategies are generally beneficial for metabolic health, individuals with PCOS often have unique dietary needs. None of the above is medical advice, and does not change any guidance you have been given by your doctor.
3. Medications and Supplements
Some medications and supplements can help. These should only be prescribed by a doctor and or another medically qualified professional. So. I won’t list these here, but speak to your doctor about this and go from there.
4. Lifestyle Modifications
- Sleep: Ensuring adequate and quality sleep can help regulate hormones that control metabolism and appetite.
- Stress Management: Reducing stress through practices like yoga, meditation, and mindfulness, or by using a gratitude journal can help lower cortisol levels, which can positively influence metabolic rate.
Navigating the PCOS Weight Loss Journey: Insights from Experience
As a weight loss coach, I’ve had the privilege of working with many women navigating the complexities of PCOS and weight management. One common thread I’ve observed is the immense frustration from feeling like they’re doing everything right, yet the scale doesn’t budge.
For example, I once worked with a client who was doing all the “right” things – tracking calories carefully and exercising regularly – but still felt like nothing was changing. We took a closer look at her habits and daily routine, and made a few key tweaks: upping her protein, getting into a simple strength training routine (even just 20 minutes, three times a week), and building in some proper stress management. Nothing extreme. Just consistent, realistic changes that helped her body start responding again. It took time, but those small, targeted shifts made all the difference.
This highlights that while PCOS presents unique hurdles, understanding these challenges and applying targeted, consistent strategies – often with patience and professional guidance – can make a real difference. It’s about working with your body, not against it.
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