As PCOS has gained more attention in recent years, there has emerged a great deal of conflicting and confusing online advice on how to manage the symptoms of PCOS – as well as how to lose weight with this condition. With 60% of women who have PCOS being overweight, it’s about time that some sound advice is offered that doesn’t consist of generic advice like “eat healthier and move more.”
At Embla, we are committed to providing evidence-based recommendations that aim to empower, support, and provide comfort to anyone with PCOS, as well as help you manage your symptoms and achieve sustainable weight loss.
So, for this article, we’ll cover the 10 best science-based tips to lose weight with PCOS. But before we do that, let’s get some clarity on what kind of condition PCOS is.
What is PCOS?
Polycystic ovary syndrome (PCOS) is a hormonal condition that affects up to 1 in 10 people with ovaries.
With PCOS being a syndrome, this means there is a collection of symptoms, some common and some rare, which can make it quite difficult to diagnose. This is exactly why the one-shoe-fits-all approach just doesn’t work.
The most common symptoms of PCOS
One of the most common symptoms you might experience with PCOS is having “cysts” on the ovaries. Despite the name "polycystic ovaries," further investigation has shown that the condition is not actually caused by cysts.
Rather, it is characterised by fluid-filled sacs called follicles, which surround the eggs in the ovaries.
Other common symptoms of polycystic ovary syndrome (PCOS) include:
- Irregular or absent periods
- Higher levels of androgens (male-type hormones such as testosterone)
- Excessive hair growth (particularly on the face and chest)
- Food cravings (especially for carbohydrate or sugary foods)
- Depression
- Anxiety
- Binge eating
- Sleep disturbances and/or sleep apnea
How to lose weight with PCOS (10 tips)
Although PCOS does not directly prevent weight loss, I think we can agree that a lot of the symptoms can make it challenging to adopt lifestyle changes that promote weight loss.
For example, In PCOS, our body's cells can become less responsive to insulin, leading to a risk of insulin resistance. Insulin is a hormone that controls blood sugar levels. Therefore, insulin resistance can affect our blood sugar levels which can contribute to elevated hunger and cravings.
This often leads to us reaching for high-sugar foods, as our brain knows where it can get fast-releasing energy from (hence why we never seem to crave carrots) to try and bring our blood sugar levels to a normal state. Fortunately, there are ways we can manage symptoms which will make it easier to develop healthy habits to aid weight loss based on existing research. It is important to acknowledge that when we solely focus on weight, we tend to overlook everything else.
This narrow focus can easily lead us to get stuck in the vicious cycle of weight loss. This cycle typically involves counting calories, and over-restricting food intake then leading to feelings of out of control. As mentioned previously, the pressure to lose weight can cause this behaviour. If we consider lean PCOS, women who are not overweight still experience similar symptoms. In such cases, what should these individuals do? As the usual go-to advice is to lose weight. This indicates that weight is not the sole cause of PCOS, rather it is a result of symptoms such as elevated insulin and testosterone levels.
Therefore, addressing these underlying issues is more likely to lead to weight changes than simply focusing on weight loss alone. Yes, there is evidence suggesting that a 5-10% reduction in body weight can help improve insulin and androgen levels in individuals with PCOS. However, it can be argued that these improvements are a result of adopting a healthy lifestyle, which may be independent of weight loss.
1. Prioritise complex carbohydrates over simple ones
We often hear advice to cut out carbohydrates for many reasons, one of which is to help with PCOS symptoms. Poor carbohydrates always seem to receive an unnecessarily bad reputation. But, if we look at the evidence regarding carbohydrates and PCOS, the results are inconclusive due to variability.
In many studies claiming to test low-carb diets, the percentage of carbohydrates can range from 20% to 45% of energy intake. As a result, some studies report the beneficial effects of low-carb diets when they are not actually low-carb.
So the takeaway message should be that carbohydrates are important in some way but we do not have to be restrictive. There is evidence suggesting that consuming a high carbohydrate diet can have a negative impact, but following a really low and restrictive diet is not a viable solution either. Such diets can have a detrimental effect on our mental health and increase the risk of disordered eating.
Carbohydrates are essential for good health as they provide essential nutrients and promote gut health. Instead of focusing on reducing carbohydrates, it's better to concentrate on the type of carbohydrates we consume. We want to opt for complex carbohydrates more often than simple carbohydrates. Complex carbohydrates take longer to break down into glucose, therefore the rise in blood sugar and insulin levels increase gradually and are easier to manage. This helps with appetite regulation and overall energy levels.
This doesn’t mean we are doomed if we eat simple sugars (e.g. biscuits, ice cream), in fact, a great way to include these foods in a balanced way is to pair them with something that is high in fibre, protein and/or healthy fats. This combination will slow the release of glucose into the bloodstream. For example, pairing ice cream with some bananas, berries and a sprinkle of seeds.
2. Aim for 30g of fibre daily
Fibre is a type of complex carbohydrate. High-fibre foods like whole grains, beans/legumes, nuts/seeds and fruit and vegetables, can help manage blood sugar levels, keeping them stable.
The higher the fibre content, the higher the amount of time it takes your body to digest, so you won’t have a big spike in your blood sugar and subsequently a spike in insulin.
Focus on getting 30g of fibre daily and include a rainbow variety of fruits and vegetables. This will naturally increase antioxidants and work to reduce PCOS inflammation. It will also increase essential prebiotics to feed gut microbes.
3. Eat more protein (include it in every meal and snack).
Adding protein can also help reduce the speed at which we digest our food, which again, has a positive impact on blood sugar control.
This process means that our appetite is more likely to be regulated- feeling fuller for longer. It helps in terms of body composition too. When we think about weight loss, the typical focus is the number on the scale, but actually, body composition is much more important for those with PCOS because it’s a metabolic condition.
So what we are trying to do is keep all those hormones balanced and if you have more muscle tissue it is going to positively impact your insulin levels and insulin resistance. Having enough protein in your diet helps you maintain muscle mass. Aim to have protein in every meal and snack, helps maintain the blood sugar levels and also gives you a good amount of protein overall.
4. Get more healthy fats through fish
As women, we need a good amount of fat for our reproductive health and to keep our cycles regular.
Healthy fats can be beneficial for managing inflammation related to PCOS. Oily fish is a rich source of omega-3 fats, which can help reduce inflammation commonly seen in individuals with PCOS.
We want to be aiming to consume one to two portions of oily fish per week. Additionally, try to incorporate plant-based sources of omega-3 fats, such as seaweed, algae, chia seeds, flaxseeds, and walnuts.
5. Get more physical activity in your day
There are many benefits to be gained from being physically active but the most relevant to PCOS is that it improves your body’s response to insulin.
Many types of movement have been shown to support PCOS management.
These include:
- Strength/resistance training,
- Cardiovascular and HIIT training
- Gentle forms of movement like yoga
Resistance training can be useful because as we mentioned previously, body composition is important for PCOS. It’s important to find something that we enjoy and can fit into our lifestyle.
Guidelines suggest aiming for 150 minutes per week of moderate intensity activity or 75 minutes per week of more vigorous activity, and including some strength/resistance training twice a week. But if it's a struggle to fit exercise sessions in, starting with general movements throughout the day can make a huge difference.
For instance, regularly moving from the desk, squats or walking when cleaning teeth, having a 10-minute walk at lunchtime, walking to and from the shops etc. All forms of movement count and breaking up sitting time is really important
6. Eat less processed foods (like sausages, biscuits, cereal)
The trillions of microbes, including bacteria, in our gut, impact our health and happiness.
When it comes to PCOS, studies have shown that women with PCOS have less good bacteria and more bad bacteria than normal. Poor gut bacteria has been shown to cause inflammation and insulin resistance.
Ways you can improve your gut health is to reduce the amount of ultra-processed foods (UPF) where possible. UPF often contains high levels of saturated fat, salt and sugar. Eating a large amount of them leaves little room for the more nutritious, less-processed foods in our diet.
Studies have also found a link between the consumption of UPF and inflammatory bowel disease (IBD) suggesting that high intakes of UPF can change the gut microbiota and lead to inflammation.
UPF are foods such as:
- Sausages
- Chicken nuggets
- Crisps
- Mass-produced bread
- Added sugar breakfast cereals
- Biscuits/cakes
- Added-sugar carbonated drinks
- Added sugar yogurts
- Instant soups
- Ice cream
- Vegetable/vegan patties (meat substitutes)
As highlighted earlier, foods that are high in fibre are good for the gut and these foods are usually (if not always) unprocessed.
7. Eat more fermented foods (like kombucha, sauerkraut, kefir).
Following on from this, adding fermented foods to the diet may have a positive influence on our gut health and PCOS symptoms.
Fermented foods often contain probiotics which are foods with living microbes that travel to the gut and serve as food for the good microbes living in the gut.
Some common fermented foods to try include:
- Kombucha (fermented tea)
- Kefir (fermented milk, or sugary water if you use water grains)
- Live yogurt
- Sauerkraut (fermented cabbage)
8. Avoid eating too little
With the pressure and desperation to lose weight, we may result in dramatically making changes to our diet and lifestyle to lose the pounds fast.
But by doing this, we are putting our body under a huge amount of stress.
We basically send a message to our brain that there isn’t enough food available, and we need to start conserving our energy. This makes weight loss and weight maintenance more difficult.
Eating less or eliminating certain food groups won’t help improve PCOS symptoms either. We need to be including all food groups in proportion as every nutrient has a role to play in our health. Calorie restriction or trying fad diets is not sustainable in the long-term and many women have in fact experienced that their symptoms have worsened after trying fad diets. We should visualise our diet as a way to nourish ourselves instead of starving our bodies.
9. Manage your stress
Our stress levels can have a negative effect on your PCOS treatment journey.
Cortisol is an essential hormone released by our body in response to stress. We are familiar with the term “fight or flight” response, well this mechanism causes our body to have an increase in blood glucose levels so we have the energy to survive the situation, to handle the stress and to recover from injury.
However, we don’t want cortisol to stick around for too long in the body but unfortunately, for many of us, our stressful lifestyles are causing our bodies to release cortisol too frequently.
Women with PCOS have been shown to have higher levels of cortisol levels than women who don’t. It’s not surprising if we consider the symptoms that are associated with PCOS and the stigma around weight.
Stressing less is easier said than done, but we should try to manage and reduce it as much as we can. Learning how to manage your stress can help you deal with stressful situations in the long-run. Meditation, journaling, breathing exercises, practising mindfulness, can all be helpful.
10. Commit to practising better sleeping habits (or seek help, if needed).
Sleep plays a vital role in maintaining overall health and hormonal balance.
It has been shown to reduce cortisol levels, as during rest, our bodies repair, restore, and regulate various physiological processes. Lack of sleep affects the regulation of appetite-controlling hormones, such as ghrelin and leptin.
Ghrelin, known as the “hunger hormone,” increases with sleep deprivation, leading to increased feelings of hunger and cravings for high-calorie foods. This is because these types of food offer the body quick releasing energy – making up for the energy it loses through the lack of sleep.
This hormonal imbalance can contribute to overeating and weight gain, which can further exacerbate PCOS symptoms. For those who experience sleep problems for whatever reason (insomnia, stress etc), saying get more sleep is again easier said than done, but it’s really important to be working on increasing your sleep quality.
Practising good sleep hygiene such as maintaining a sleep schedule, turning off all electronic devices and practising relaxation techniques can all help improve sleep quality. Speaking with a sleep specialist could also be an option if you are really struggling.
Balance is key (and stop being so hard on yourself)
In summary, PCOS is a complex syndrome that can affect women in many different ways, so the idea of giving “one-size-fits-all” advice is nonsense.
It’s also clear from the evidence provided that there’s a whole host of reasons why women with PCOS may find it challenging to make lasting lifestyle changes that help with weight loss, but it doesn’t mean it's impossible.
We just need to take an approach that looks at the whole picture rather than focussing solely on a number on the scale. It's not a single diet and it’s not about gutting single foods out. Following a balanced, nutritious diet is key in managing all the symptoms of PCOS. A diet that is rich in whole foods such as grains, fruits, vegetables, protein, fats and dietary fibre can help correct the hormonal imbalance. A PCOS-friendly diet is about maintaining balance in everything we eat, as every nutrient has a role and place in your daily diet.
So, let's start taking care of our bodies, making small changes over a longer period of time to avoid stress and damage and above all else - stop being so hard on ourselves.
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