The PCOS Plan book review: how to beat PCOS using diet and fasting

The PCOS Plan is a striking read that will challenge everything you know about conventional PCOS treatment.

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Authors Nadia Brito Pateguana, a naturopathic doctor who has PCOS, and Jason Fung, a doctor and fasting expert, make provocative – and science-backed – claims.

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Central to their argument is that many conventional PCOS medications only mask, not cure, your most aggravating symptoms.  And, honestly, it might be jarring to read because you’re bound to have tried at least one of these treatments.

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One of the PCOS Plan's strengths is Pateguana's personal experience; she speaks in detail about her frustrations with the healthcare system and her PCOS-related health problems.  The result is a highly relatable narrative. One that will leave you questioning previously held beliefs about PCOS, birth control, weight loss, and more. 

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Counting calories is useless for PCOS weight loss

Pateguana and Fung devote a substantial chunk of the book to exploring the link between hormones and PCOS. You’ll find straightforward definitions for concepts like insulin resistance, hyperandrogenism, and anovulation. 

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One of the key takeaways is that simply tracking calories isn't effective weight loss strategy. That's because any successful weight loss plan must also account for the role of hormones, writes Pateguana and Fung.

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To illustrate this point, the writers share a practical example. Take two different foods that contain the same amount of calories: 200 calories of salmon and 200 calories of cookies. Cookies, a refined carbohydrate, will trigger a strong insulin response. Insulin, in turn, instructs the body to store fat. Not only that but cookies won’t activate the hormones that reduce your appetite.  The result? You’ll still feel hungry after binging on those cookies. By contrast, salmon doesn’t stimulate insulin as much and activates fullness hormones.

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Clearly, this makes salmon less fattening and more filling.

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“Despite ample evidence that shows 200 calories of cookies are not equal to 200 calories of salmon, as a society we still believe that calories are the most important determinant of weight gain," write Pateguana and Fung.

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But if counting calories isn't a reliable way to lose weight, why does this practice persist? The "calorie myth" is so entrenched due to major manufacturing companies and their well-funded ad campaigns, suggest the authors:

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"Snack food manufacturers have spent millions of dollars convincing us that all calories are equally fattening. Cookie makers do not want you to believe that cookies are more fattening than beef. Candy makers do want you to know that candy is more fattening than spinach. No, that’s no way to sell cookies and candy.” 

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And just like what you eat is important, when you have your meals matter too. Food is more fattening later in the day because your body is focused on storing, rather than using, the fat.

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There’s a lot of technical medical information in this section and the authors explain everything in fairly easy-to-understand terms.

The pitfalls of conventional PCOS treatment 

Pateguana,  and Fung, do a deep dive into many standard PCOS medical treatments, confronting the widespread prescription of these medications. In these excerpts, Pateguana’s personal journey shines through. PCOS affected not only her ability to conceive but also her overall health.  Over the years, she tried everything to relieve her symptoms:

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“I have been living with PCOS for more than 20 years, taken close to ten different medications, and undergone numerous medical procedures to mask the different expressions of this condition.”

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Pateguana details specific encounters with doctors. Here, you might be able to identify with her feelings of hopelessness and despair. She didn't the receive support she needed to manage her PCOS, even right after her diagnosis.

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"When my doctor diagnosed me with POS, dietary management did not even enter the discussion...he also knew the connection between PCOS and obesity, and yet he assumed that I was resigned to the fact that I would become obese. And then...he showed me the door."

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Throughout the material, she also shares case studies, stories from her own patients and their treatment plans. All to say, she has significant personal and professional experience in a wide range of PCOS treatments.

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In her review of common PCOS medications, Pateguana focuses specifically on the birth control pill and Spironolactone. The pill is the most widely used treatment. It improves period regularity and reduces androgen levels. Similarly, Spironolactone reduces the symptoms of high androgen levels, most notably excess hair and acne.

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But the reality is none of these pills address insulin resistance. Therefore your symptoms are doomed to resurface once you stop taking the medication.

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Personally, this section was a major eye-opener. I believed the pill regulated my period. For years. Then I discovered I was only experiencing a withdrawal bleed each month, not a true period. I also figured out why my acne began to reappear straight after got off the pill.

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If anything, the information you find here will support you to ask deeper questions during discussions with your medical health provider. It's worth noting specific concerns and taking them along to your consultation.

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Intermittent fasting eases PCOS symptoms 

What’s interesting is that Pateguana was able to reverse her symptoms entirely through lifestyle management.

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“...I have not taken medication for hyperglycemia, hypertension, or depression again. I have no more symptoms of PCOS or irritable bowel syndrome. This lifestyle has been very sustainable for me, and I hope the same for you.”

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It’s no surprise, then, that the PCOS Plan makes a strong case for PCOS and intermittent fasting. Pateguena and Fung explain that intermittent fasting reduces insulin. This means it tackles the core problem for many people who have PCOS: insulin resistance.

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Again, the authors challenge mainstream diet advice here. They argue, for instance, that snacking can hinder, not support, weight control efforts.

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This section contains especially practical tips for starting intermittent fasting. It’s a valuable resource if you’re ready to get started with a low-carb eating plan and intermittent fasting regime.

PCOS: ancient illness with a simple cure?

If you have PCOS, you've probably tried it all. Birth control pills, antibiotic skin creams, calorie counting, and more. The PCOS Plan suggests there might be different way, a better way, to ease your symptoms.

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