PCOS Weight Loss: A Proven 5-Step Plan That Actually Works

Up to 61% of women with PCOS are overweight. 

And when it comes to PCOS, weight loss isn’t as simple as cutting calories and waiting for the unwanted weight to drop. That’s because PCOS is typically linked to a ton of hormonal imbalances. And these imbalances not only cause weight gain but also difficulty in losing weight.

Getting rid of excess body weight with PCOS isn't impossible, but it requires a long-term commitment to weight management. 

In this post, we’re looking at practical tips for weight loss for PCOS. I followed these steps to drop 13 kg.

Is it difficult to lose weight with PCOS?

According to the Human Reproduction journal, women with PCOS gained more weight annually compared to women without PCOS. 

As mentioned, PCOS weight gain is usually tied to a hormone imbalance. In fact, several hormone problems are associated with the classic PCOS body shape. One example is insulin resistance, which can cause the body to store more fat. Plus, elevated levels of cortisol are also connected to weight gain, especially around the belly. Like cortisol, high testosterone is tied with extra weight around the midsection. And this is exactly why some of us have the PCOS belly. Even at my thinnest, I've always carried some extra padding around my waist.

But there's good news, too. While we’re more prone to weight gain, research shows lifestyle factors like stress, diet, and exercise, can have a significant impact on body weight. In particular, eating a healthy diet is essential for weight management in PCOS. Exercise is also important. There's tons of research to  show physical activity can improve insulin sensitivity and reduce androgen levels. Even better, it can help to reduce stress, which can also contribute to weight gain.

Finally, certain medications, such as metformin, can help to reduce insulin resistance and improve weight management.

How to lose weight with PCOS: 5 research-backed steps 

PCOS weight gain is incredibly frustrating. It can mess with your body image and self-confidence. However, as we know, packing on extra weight may also signal a more serious health problem. 

My personal weight loss journey began during the COVID-19 lockdown. I had lean PCOS for years. So although I was quite skinny, I had all the usual PCOS symptoms:  irregular periods, excess facial hair, and acne.

Then, during the COVID lockdown I wasn’t allowed to leave my house. I also made a ton of poor food choices...for months. My diet was high in refined carbs and sugar, and I was pretty much glued to my office chair or couch. Pretty soon, I gained 13 kgs. 

‍

Once I committed to a weight loss programme, though, I was dropping about 2kg each month. A year later I'd lost 13 kg. During that time, I ate mostly low-GI foods, did yoga regularly, walked every day, and started weekly therapy sessions to better manage my stress. 

Below, we'll focus on how to lose weight with PCOS naturally.

Step 1: Understand how to manage insulin resistance

There’s an established link between insulin resistance and PCOS.

According to the 2022 World Journal of Diabetes, insulin resistance is found in 35% to 80% of PCOS cases. 

When you have insulin resistance, your body doesn’t respond properly to insulin. This leads to elevated levels of insulin in the bloodstream and is tied with several PCOS symptoms, like weight gain, according to Scripps:

“Losing weight with insulin resistance is more difficult because the body stores excess blood sugar as fat.”

A good first step to dealing with PCOS weight gain is to test your insulin levels. To track your progress, have them checked again after you’ve taken steps to get your insulin levels under control. 

To manage insulin resistance, focus on reducing carbohydrate intake and incorporating healthy fats into your diet. Nadia Brito Pateguana, naturopathic doctor and co-author of the PCOS Plan, also recommends intermittent fasting for PCOS. Everything you eat triggers an insulin response, and restricting the window when you consume food lowers insulin.

Step 2: Choose the right foods for PCOS weight loss

Making dietary changes is often the first step in managing PCOS weight.   

The ideal PCOS diet addresses insulin resistance, leading to weight loss and an improvement in other hormone levels. Fortunately, a couple of diets have been studied for how effective they are in treating PCOS. Specifically, PCOS nutrition experts recommend eating a diet that is low in sugar and processed foods can promote weight loss, reduce chronic inflammation, and regulate hormones.

One such eating pattern is a low-glycemic index (GI) diet. Researchers looked at data from randomised controlled trials and found a low GI diet had a positive effect on insulin and androgen levels, according to a systematic review published in the 2021 Advances in Nutrition journal.

Low-GI foods have less of an impact on your blood sugar levels than high GI foods. You’ll consume more: whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables 

Conversely, a low-GI eating limits refined grains like pasta and white bread. Other high-GI foods to avoid include fruit juice and some breakfast cereals. You can check the GI of foods here.

The Mediterranean diet has also been linked with better health outcomes for PCOS. A research review published in the 2023 Current Nutrition Reports showed the Mediterranean diet was linked with lower inflammation. PCOS is connected with chronic low grade inflammation. A Mediterranean diet emphasises fruits, vegetables, seafood, and olive oil.

My approach to managing my weight through diet is to try to eat healthy most of the time. This means not having sweetened drinks in the house - it's either still or carbonated water. For a snack, I'll usually reach for a smoothie or nuts. A simple fix was to cut out fast and highly processed foods. 

Still, I absolutely have periods where I binge on fast food. And my body tells me it's unhappy almost immediately. My energy levels drop and I start breaking out. 

Step 3: PCOS workouts for weight loss 

Making regular physical activity a habit is one of the best things you can do for your weight and overall health.

In a systematic review into the effects of exercise on hormone levels in women with PCOS, aerobic exercise was found to improve insulin, while strength and weight training lowered androgen levels. Evidence also suggested that yoga was helpful for regulating testosterone. 

Other research, performed by a team of researchers from the UK, suggests that 150 minutes of exercise per week is a good guideline for PCOS.

Combine cardiovascular exercise, such as brisk walking or cycling, with strength training exercises to promote weight loss. Most importantly, look for activities that you enjoy to make exercise a sustainable part of your lifestyle.

Honestly, I was probably the least active person out there before I understood the importance of exercise. But I found I couldn't stick to big, overwhelming workouts.  Instead, I attended weekly yoga classes and once I had the basics down, I opted for online classes on YouTube. Some days these were as short as 5 minute yoga sessions. Most days, I walked. I looked forward to listening to an audiobook or podcast during my walks. 

Step 4: Practice stress management

‍

Women with polycystic ovary syndrome (PCOS) are prone to stress and this can worsen weight gain, according to research published in the Human Reproduction journal.

One theory is that stress can lead to unhealthy food choices. Additionally, stress drives up cortisol levels, which in turn lead to fat storage, as Gabrielle Mancella, registered dietitian, notes in Orlando Health:

“Cortisol stimulates your fat and carbohydrate metabolism, creating a surge of energy in your body. While this process is essential for survival situations, it also increases your appetite. Additionally, elevated cortisol levels can cause cravings for sweet, fatty and salty foods. This means you’re more likely to indulge in french fries and a milkshake than you are a well-balanced meal.” 

Try stress management techniques such as mindfulness, meditation, and self-care practices. Taking time for yourself each day can help to reduce stress and improve overall health. For me that meant, taking a warm Epsom salt bath and reading on the couch after the kids went to sleep. I also saw a therapist for weekly sessions, and this decision made a world of difference to my well-being.

Step 5: Work with a trusted healthcare professional

Working with a healthcare professional experienced in PCOS management can make a massive difference to your weight loss efforts. 

I consulted with an aesthetic doctor and integrative doctor who helped me find the best supplements and diets to manage my PCOS.  As part of my treatment programme, she ran a couple of blood tests basing her recommendations on my results.

‍

Kickstart your weight loss journey with PCOS

The truth is losing weight with PCOS is challenging, but with the right strategies and support, it’s possible to reach – and maintain - a healthy weight. 

Lifestyle changes, like a well-balanced diet, regular exercise, stress management, and working with the right healthcare professionals, will put you on the right path. 

It’s also to remember that weight loss is not the only measure of success. For instance, better energy levels and sleep are also great indicators of progress. 

‍

Don’t feel discouraged if you don’t drop weight right away or you’re not seeing the results you want. I know I’d watch the scale obsessively, and I’d feel incredibly disappointed if the number moved the wrong way or stood still. I was able to reach my goals over time and with consistency, and you can too. 

 Featured image credit: Photo by bruce mars on Unsplash

‍