Why it’s so hard to lose weight if you have PCOS

How does PCOS cause weight gain?

Of the estimated 5 million American women with Polycystic Ovary Syndrome (PCOS), between 40 and 80 percent find weight management a challenge. What gives? Well, as you know, PCOS is a hormonal disorder—and hormones affect many systems in your body, including those that help regulate body weight. Let’s take a look at how this could impact your personal weight care journey.

The insulin effect

Insulin is a hormone that’s made in the pancreas. When you eat or drink, insulin is released to help manage blood sugar levels—directing it to be used for energy or stored as fat.

People who are insulin resistant typically don’t respond to it properly. That means the hormone is less effective, and their body has to release more of it for it to do its job. This may cause problems with blood sugar regulation, which can worsen over time and lead to type 2 diabetes. High insulin levels also promote body fat storage and weight gain.

Women who have PCOS are at a higher risk for insulin resistance. Being overweight or obese is associated with insulin resistance, as well. So women with both may be at an even greater risk, resulting in a feedback loop that can make weight care and overall wellness more difficult to manage.

Androgen production

Androgens are a group of hormones that include testosterone and dihydrotestosterone (DHT). Women with PCOS tend to have higher levels of these hormones, which actually contribute to some of the symptoms related to the condition. Androgens have also been linked to weight gain—particularly in the belly.

Irregular sleep

Sure, sleep is crucial to your overall health and well-being. But it has specific ties to metabolism, too. Because women with PCOS appear to be more prone to sleep disturbances, they’re more likely to experience the weight care challenges that result from inadequate rest. How does PCOS affect your Zzzs? Hormonal imbalances may play a role here, altering levels of cortisol and melatonin in the body that are known to impact sleep. Having PCOS also makes you over nine times more likely than other women to have sleep apnea—a condition that leads to breathing irregularities at night.

Plus there’s the fact that poor sleep in general can mess with hormones—like leptin and ghrelin, that help regulate appetite—further complicating weight care.

Mental health

Finally, women with PCOS have been found to experience higher rates of anxiety and depression than those without the condition. There are a variety of reasons, but it’s clear that mental health struggles can impact sleep, quality of life, and the ability to consistently make lifestyle choices that can affect weight care.

Tips for managing your weight

The odds may be stacked against you when it comes to weight and weight loss, but impossible? No way! Start by talking to your healthcare provider to make sure you know precisely how PCOS is affecting you. And consider these lifestyle pointers.

Adjust your diet

Reducing insulin resistance is often recommended as a starting point for managing PCOS symptoms and weight. So focus on healthy, fiber-rich foods and try to keep hyper processed ones (which can spike blood sugar) to a minimum. While there’s some data that suggests lower carbohydrate diets may be more effective for those with PCOS, making nutritious food choices and maintaining a regular eating pattern are what matter most.

Stay active

Being sedentary has been linked to many conditions, including PCOS, type 2 diabetes, obesity, and depression. So let’s move! Aim to fit in 150 minutes of moderate aerobic activity each week—and do some sort of strength-building exercise at least twice a week. And make it a type of movement that you enjoy. That’s 1,000 percent key to sticking with it.

Prioritize your sleep

This one can be more of a challenge given the ways that PCOS can impact how well you sleep, but it also makes it that much more important. Here are some pointers: 

• Monitor your sleep – Keep track of how much shut-eye you’re getting, and—equally important—the quality of the sleep you get. (Use that fancy smart watch of yours!) Pay attention to how you feel during the day, too. If you don’t feel rested when you wake up, or feel drowsy during the day, it could point to poor sleep quality.
• Stick to a consistent routine – Try to wake up at the same time each morning. Not always easy, we agree, but it’s a pillar of good sleep hygiene. The more regular your schedule, the easier it will be for your body to adapt to that schedule so you get the deep rest you need. 
• Create a sleep-friendly environment – Make your bedroom as comfortable, dark, and quiet as possible. Keep it as free of distractions as you can (*cough, phone, cough*) and try to reserve it as a space that’s primarily used for sleep.
• Make sleep-friendly choices during the day – Drinking alcohol in excess, having caffeine late in the day, and eating right before bed can all have an impact on how well you sleep. Be mindful of the choice you make, and think about whether any that may be affecting your sleep.
• Consider a sleep study – If you think you may have an issue such as sleep apnea, consult with your healthcare provider to see if sleep study may be right for you. Your weight and your overall health could thank you. 

Take care of your mental health

What this looks like is totally unique to you. Maybe it’s seeing friends, taking a hot bath or going to an endorphin-boosting yoga class. Maybe it’s therapy. Either way, it’s important to prioritize your emotional well–being!

Get support from Found

There’s no question that biology affects body weight for women with PCOS. At Found, we focus on your unique physiology and needs to help you during your unique health journey.

About Found

Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.