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Managing Weight Gain with PCOS: Key Insights

Written by Andrew Le, MD

UpdatedFebruary 29, 2024

Weight gain is a common concern for many women. Still, those dealing with polycystic ovary syndrome (PCOS) often struggle to shed excess pounds.

Approximately half of women with PCOS are overweight or obese, which raises the stakes due to potential health complications like fatty liver, hypertension, high cholesterol, and insulin imbalances. Left unchecked, these risks could even lead to heart disease, stroke, or diabetes.

In this article, you will learn the relationship between PCOS and weight gain, explore the associated health risks, and provide insights into effective weight management strategies.

What is PCOS?

PCOS is a common genetic hormonal disorder primarily affecting people of reproductive age, particularly those assigned to females at birth.

Hormonal imbalances characterize it and can impact fertility, metabolism, and appearance. Roughly 8-13% of reproductive-aged women are estimated to have PCOS, with up to 70% going undiagnosed worldwide.

But what happens when you have PCOS? Let's examine its symptoms, causes, diagnosis, and treatment.

Symptoms of PCOS

The symptoms of PCOS can vary widely among individuals. Still, they often include:

  • Menstrual Irregularities: Absent or infrequent periods (amenorrhea or oligomenorrhea), heavy bleeding, or anovulatory periods (bleeding without ovulation).
  • Excess Androgens: Elevated levels of androgens, often referred to as male hormones, can lead to symptoms such as excess body and facial hair (hirsutism), severe or persistent acne, and male-pattern baldness (androgenic alopecia).
  • Ovarian Abnormalities: Some individuals with PCOS may develop ovarian cysts, although recent evidence suggests that these are immature ovarian follicles that have not fully developed.
  • Insulin Resistance: PCOS can cause insulin resistance, which results in high insulin levels in the bloodstream. This can contribute to weight gain, difficulty losing weight, and an increased risk of type 2 diabetes.
  • Metabolic Disturbances: PCOS is associated with metabolic syndrome, including obesity, high blood pressure, and abnormal cholesterol levels.
  • Skin Changes: Dark, velvety patches of skin known as acanthosis nigricans may develop, particularly in areas where skin folds or rubs together.
  • Fertility Issues: Anovulation and hormonal imbalances can lead to difficulties conceiving and an increased risk of infertility.

Causes of PCOS

The exact cause of PCOS is not fully understood, but it is believed to be acomplex interplay of genetic and environmental factors.

While there is evidence of genetic involvement, the genes responsible for PCOS are not yet identified. Hormonal imbalances, particularly elevated androgens and insulin resistance, play a central role in developing PCOS.

Diagnosis of PCOS

Healthcare providers diagnose PCOS based on clinical and laboratory criteria. These may include:

  • Menstrual History: Irregular or absent periods are often a key indicator.
  • Physical Examination: Hirsutism, acne, and other signs of androgen excess can contribute to the diagnosis.
  • Blood Tests: Hormone levels, including androgens and insulin, are measured. Elevated levels can suggest PCOS.
  • Pelvic Ultrasound: Ovarian cysts or follicles may be detected through ultrasound imaging.

Diagnosing PCOS involves considering multiple factors and ruling out other conditions that may present similar symptoms.

Treatment and Management

While there is no cure for PCOS, there are various approaches to manage its symptoms and reduce associated health risks. Treatment options may include:

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  • Lifestyle Changes: Weight management through a healthy diet and exercise can help improve insulin sensitivity and hormonal balance.
  • Medications: Birth control pills or other hormonal medications may regulate menstrual cycles and manage symptoms like excess hair growth and acne.
  • Insulin-Sensitizing Medications: Medications like metformin can improve insulin resistance and metabolic factors.
  • Fertility Treatments: Individuals trying to conceive may receive treatments to stimulate ovulation, such as ovulation-inducing medications.
  • Anti-Androgen Medications: These can help manage androgen-related symptoms like hirsutism and acne.
  • Mental Health Support: Addressing mood disorders and mental health challenges that may be associated with PCOS is important.
  • Regular Check-Ups: Monitoring symptoms, hormone levels, and health markers are important for managing long-term health risks.

🩺 A Doctor’s Note:

Treatment approaches can vary based on individual needs and goals. Effective management of PCOS often involves a multi-faceted approach that addresses physical and emotional well-being.

How Does PCOS Affect Weight Gain?

PCOS can significantly impact weight due to:

  1. Insulin resistance
  2. Hormonal imbalances
  3. Metabolic changes

Insulin resistance

It is a key factor where the body struggles to transfer glucose from the bloodstream into cells for energy. As a result, the pancreas produces more insulin to maintain blood sugar levels. This excess insulin can lead to weight gain and other symptoms.

Over time, the body may overproduce insulin, contributing to further weight gain.

Hormonal imbalances

This is particularly elevated androgens, which play a role in fat distribution.

Women with PCOS may experience weight gain around the abdomen, leading to an apple-shaped body instead of the typical pear-shaped body. This abdominal fat accumulation is concerning, as it increases the risk of heart disease and other complications.

Metabolic issues related to PCOS

Issues like slower metabolism and disrupted appetite regulation, can also contribute to weight gain. These factors combined create a challenging environment for weight management for many women with PCOS.

What Risks Come With Weight Gain And PCOS?

Weight gain with PCOS increases the risk of complications, including:

  • Type 2 Diabetes: Insulin resistance in PCOS increases the risk of developing type 2 diabetes. Elevated insulin levels due to insulin resistance can lead to glucose intolerance and diabetes over time.
  • High Cholesterol: Weight gain, particularly abdominal fat, can lead to high cholesterol levels, increasing the risk of heart disease and stroke.
  • High Blood Pressure: Obesity is a risk factor for high blood pressure. Women with PCOS who gain weight may be at an increased risk of hypertension, raising the risk of cardiovascular diseases.
  • Sleep Apnea: Weight gain can contribute to sleep apnea, a sleep disorder characterized by breathing interruptions during sleep. This condition is more common in individuals who are overweight or obese.
  • Infertility: PCOS-related hormonal imbalances and weight gain can affect fertility by disrupting ovulation and menstrual regularity. Losing weight can improve fertility by restoring hormonal balance and ovulation.
  • Endometrial Cancer: Elevated estrogen levels resulting from hormonal imbalances in PCOS can increase the risk of endometrial cancer, particularly in women who are overweight.

How Is PCOS Weight Management Addressed?

Weight management can be challenging. However, there are several strategies you can implement to manage PCOS-related weight issues effectively:

Balancing Hormones for Weight Management

Balancing hormones is crucial for effective weight management as it helps regulate metabolism, control appetite, and optimize energy expenditure, ensuring a healthier and more sustainable approach to achieving and maintaining an ideal weight.

By addressing hormonal imbalances through lifestyle changes, such as proper nutrition, sleep, and stress management, you can enhance your body's natural mechanisms for weight control. Here are some key things to consider:

  • Oral Contraceptives: Oral contraceptives can be a valuable tool for individuals not planning to conceive. They work by regulating hormone levels, promoting a more regular menstrual cycle, and helping to manage some of the symptoms associated with PCOS.
  • Healthy Dietary Choices: Incorporating more protein-rich foods into your diet can positively impact hormone balance. Protein intake stimulates the release of hormones that promote feelings of fullness and satisfaction, which can help control appetite and reduce overeating.
  • Gut Health: A healthy gut microbiome plays a crucial role in hormone regulation. Add fermented foods, such as yogurt, kefir, sauerkraut, and kimchi, to your diet. These foods contain probiotics that support gut health and may contribute to better hormonal balance.

Strategic Diet for Weight Loss

A strategic weight-loss diet involves adopting a low-carbohydrate approach by focusing on low-glycemic-index carbohydrates like whole grains, fruits, and vegetables to manage blood sugar levels. Aside from this, it must also involve:

Fiber-Rich Foods

Boost your fiber intake for even more effective results. A study with 57 participants found that those who consumed more fiber had lower body weight, reinforcing the value of fiber-rich foods. This approach slows digestion, stabilizes blood sugar, and aids weight management, reducing the risk of insulin resistance.

Healthy Fats

Include healthy fats in your meals for improved satisfaction and hormone regulation. Although calorie-rich, healthy fats like avocados, olive oil, nuts, and fatty fish can expand stomach volume and curb hunger, potentially reducing calorie intake throughout the day. These fats also provide essential nutrients that support hormonal balance and overall health.

Effective Exercise Regimen

An effective exercise regimen for weight loss in individuals with PCOS involves:

  • Aerobic Exercise: Regular aerobic exercise improves insulin sensitivity and promotes weight loss. Aim for at least 150 minutes of moderate-intensity cardiovascular activity per week. Activities like brisk walking, jogging, swimming, or cycling can effectively burn calories and support overall health.
  • Strength Training: Incorporate strength training into your routine to build muscle mass. Muscle tissue burns more calories at rest and helps improve insulin function. Include weightlifting, resistance band workouts, or bodyweight exercises to strengthen muscles and enhance metabolism.

Utilizing Medication for Support:

Utilizing medication for support in weight loss for individuals with PCOS involves:

  • Blood Sugar Medication: Consult your healthcare provider about the potential use of medications like Metformin to manage insulin resistance. These medications can help regulate blood sugar levels, making managing weight easier and reducing the risk of related health issues.
  • Oral Contraceptives: Birth control pills can be a valuable component of a treatment plan for managing PCOS symptoms. They regulate hormone levels, promote regular menstrual cycles, and help address issues like irregular periods and excess hair growth.
  • Weight Management Medication: In some cases, healthcare providers may recommend weight management medications to complement your efforts in diet and exercise. When used under medical supervision, these medications can assist in appetite control and weight loss.

Prioritizing Restful Sleep

Aim for 7-9 hours of quality sleep per night. Adequate sleep supports hormone regulation, including insulin and appetite-controlling hormones. Establishing a consistent sleep routine can positively impact weight management and overall well-being.

Effective Stress Management

Practice stress-reduction techniques such as mindfulness, meditation, yoga, and deep-breathing exercises. These practices help lower cortisol levels, which can contribute to improved hormonal balance and better weight management.

Mindful Eating for Weight Control

Develop mindful eating habits by paying attention to hunger and fullness cues. Mindful eating can help prevent overeating and emotional eating, promoting a healthier relationship with food and supporting your weight loss goals.

Limiting Processed Foods and Sugars

Opt for whole, minimally processed foods to stabilize blood sugar levels and facilitate weight management. Notably, processed foods and added sugars can heighten the risk of insulin resistance, a condition associated with obesity. Make informed choices to promote healthier outcomes for your body.

Supplementing Wisely

In managing weight with PCOS, thoughtful supplementation can play a role in enhancing your efforts. You may consider these supplements:

Seeking Professional Guidance

Before making significant changes to your diet, exercise routine, or medication, consult healthcare professionals or registered dietitians. Personalized guidance based on your medical history and needs is essential for a safe and effective approach.

🗒️ Related Articles:

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The Bottomline

By adopting a comprehensive strategy encompassing lifestyle modifications, medication, exercise, and supplementation, you can effectively manage weight gain and promote overall well-being.

Consistency, personalized guidance, and a multifaceted approach are essential for achieving sustainable results in managing PCOS-related weight gain.

FAQs on PCOS and Weight Gain

Can PCOS lead to rapid weight gain?

Yes, PCOS can cause rapid weight gain due to its association with obesity. Weight gain can worsen PCOS symptoms because of insulin-related issues.

Is weight gain bad for PCOS?

Yes, weight gain can worsen PCOS symptoms, but PCOS can affect women of all sizes due to insulin dysfunction, potentially leading to weight gain.

Can PCOS weight be lost?

Losing weight with PCOS is challenging but possible. Progress may be slower due to hormonal imbalances, yet a healthy lifestyle brings gradual benefits.

How do breasts look with PCOS?

Breast changes during PCOS pregnancies can be minimal, often resulting in tubular, widely spaced, or asymmetrical breast shapes.

Can you have PCOS if you're skinny?

Yes, some individuals have lean PCOS with a normal BMI, making diagnosis and treatment more complex.

Does metformin help with PCOS weight loss?

Metformin can aid in weight loss for PCOS by improving insulin response, promoting hormone balance, and enhancing metabolic health.

Can PCOS cause a big tummy?

Yes, abdominal weight gain, sometimes called the "PCOS belly," is a common symptom, distinct from other types of weight gain.

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