If you’ve got PCOS—polycystic ovary syndrome—and you’re like most women who do, your first symptoms probably had to do with monthly cycles or problems getting pregnant, and that’s what many doctors treat first. What’s often left to patients, though, is how PCOS can impact your weight care journey in big ways.
PCOS (Polycystic ovary syndrome) is when your ovaries produce an excess amount of androgens—male sex hormones that women normally have in small amounts. And it can be associated with metabolic disorders (3). Some studies show that the prevalence of overweight and obesity in women with PCOS could be as high as 80%.
The name “polycystic ovary syndrome” describes the numerous small cysts (fluid-filled sacs) that may form in the ovaries. But PCOS can present in different ways for different people. Common symptoms include:
Enlarged or “cystic” ovaries
Excess body hair, including on the face, chest, stomach, or back (hirsutism)
Acne or oily skin
Baldness or thinning hair
Skin tags (small pieces of excess skin on the neck or armpits)
Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts
Weight gain, especially around the belly
If you have PCOS and are struggling to lose weight despite your best efforts, you’re not alone! Again, many women with PCOS are also overweight or obese (6)—and we know that many of our Found members report having the condition. Healthcare providers often say that losing weight will help. And it may. But it’s not always that simple. This is in part because weight gain can stem from the syndrome itself.
While that’s a frustrating reality, understanding PCOS and what you can do to manage it can help you feel your best. I’m here to answer your top questions about the condition, how it may impact your weight care journey and what you can do about it.
For decades, it was thought that PCOS was the result of an imbalance in reproductive hormones. The condition can be genetic, but more recent data suggests that the underlying cause is often insulin resistance. This happens when your body becomes resistant to insulin, causing your pancreas to make much more than it needs. That extra insulin can lead to fat storage and weight gain. Plus, PCOS may be a double-edged sword because it might cause insulin resistance by impairing your body’s ability to produce and use insulin effectively.
Along with storing fat, insulin also acts as an appetite-stimulating hormone. As a result, it can make women with PCOS feel hungrier and experience frequent cravings that can impact weight.
But insulin isn’t the only hormone impacted by PCOS: Leptin and ghrelin are two other appetite-regulating hormones that are impaired in those with PCOS. When these hormones aren’t functioning correctly, you may want to eat more and have a more difficult time feeling full and satisfied—which, as you might imagine, can lead to overeating and weight gain.
Let’s face it: Taking the steps toward a healthier lifestyle requires time, focus, and commitment. This includes eating a balanced diet, moving your body, and getting plenty of sleep. But when your mental health is suffering, those necessary habits can, too. In obese and overweight women with PCOS, symptoms like body hair growth, irregular menstrual cycles, and fertility problems can exacerbate the complicated relationship between obesity and mental and emotional health. And unsurprisingly, women with PCOS are more susceptible to mental health problems.
In one study of 177 women with PCOS and 109 without the condition, those with PCOS scored significantly higher for anxiety, depression, and negative body image. In another cross-sectional study of 50 patients with PCOS and 41 patients without it, women with PCOS had significantly higher depression and anxiety scores compared to those who didn’t have it. A third study focusing on teenage girls diagnosed with PCOS found that they felt very little perceived sense of self-control—mainly due to menstrual irregularities and the threat of infertility. This perception of poor self-control was a predictor of depression.
Management of this condition comes down to what works for you as an individual. But here are some strategies that may help:
Work towards weight loss. Healthy weight loss can lower your insulin and androgen levels. It also may restore ovulation and menstrual regularity. You’re already on that path, so keep up the good work!
Limit refined (fast) carbohydrates. Consuming too many fast carbs (think white bread, pasta, cookies, baked goods, etc.) can raise insulin levels. But remember that the quality of your carbs matters most. So instead, try to choose complex (slow) carbohydrates like fruits, vegetables, whole grains, and beans to stabilize your blood sugar and insulin levels.
Get moving. Exercise helps to lower your blood sugar levels. If you have PCOS, increasing your daily activity and regular movement may treat or even prevent insulin resistance. Being active can help you reach a healthy weight and is good for your mental health as well. Get outdoors for a walk in the sun for a quick mood boost!
Because insulin resistance, obesity, and type 2 diabetes are on the same spectrum, weight loss, low-carb approaches, and some of the medications Found prescribes can help treat insulin resistance and resolve symptoms of PCOS.
If you have PCOS and are struggling to lose weight, work with your health care provider to find the helpful techniques that are right for you—so you can live your best life!