How To Lose Weight When You Have PCOS

How To Lose Weight When You Have PCOS

Whilst PCOS is associated with weight gain, and it can make losing weight more difficult, YOU CAN lose weight if you have PCOS.

I’ll be upfront and say I don’t have PCOS. I’ve done a lot of research to understand why it’s more difficult to lose weight when you have PCOS. Maybe you don’t even know why it’s so hard exactly. 

If you know why PCOS makes it harder, you’ll be more likely to implement the right changes you need in your life to lose weight. 

So that’s what I’ll start with before going into what you need to do to lose weight when you have PCOS.

Ps. I’m not a doctor. I am not prescribing any specific medical advice in this article. Please always listen to your doctor before me. Also, PCOS is short for Polycystic Ovary Syndrome incase you’re wondering. 


Why Its Difficult To Lose Weight When You Have PCOS

Part of what makes losing weight when you have PCOS difficult is all the rubbish information out there.

There are so many people telling their success stories and then trying to sell you their magical solution.

You don’t need to buy anything fancy to lose weight when you have PCOS- unless your doctor says so.

Yes you are unique and require a specific approach, but the principles of weight loss still apply to you.

To understand why it’s hard to lose weight when you have PCOS, you first need to understand what’s going on with your body.


PCOS 101 & Weight Loss

There are different subtypes of PCOS based on your exact symptoms.

You may have any combination of two of the following (or all three):

  • cysts on your ovaries
  • menstrual cycle irregularities
  • elevated androgens (male sex hormones)

The first two symptoms don’t really impact weight loss so much. Elevated androgens do.

Elevated androgens can alter appetite regulation resulting in greater hunger. They’ve also been associated with increased cravings for calorie dense foods (foods high in sugar and fat). This can make weight loss more difficult since it may be harder for you to control your hunger and cravings.

In addition, a very common feature of PCOS is insulin resistance, especially if you’re overweight.

Insulin resistance is where your body doesn’t respond normally to insulin. This has numerous consequences.

The main ones important for understanding PCOS are the effects of insulin resistance on adrenal gland metabolism and on the thermic effect of food.

Elevated insulin can cause your adrenal glands to produce more androgens and lead to a cycle where they create insulin resistance which then goes on to increase androgen levels even more.

The thermic effect of food is how much energy you use to digest and absorb the food you eat. It forms a small component (about 10%) of your Total Daily Energy Expenditure or TDEE. To lose weight you have to eat less calories than your TDEE.

What happens due to insulin resistance, is your thermic effect of food is decreased. This reduces your TDEE by around 100-150 calories per day.

Weight loss then becomes more difficult because your calorie requirements will be even lower. 100 calories doesn’t sound like much and it’s not. But if you’re eating in a calorie deficit for weight loss then you’ll miss those calories.

This combined with increased hunger can make it more difficult to consistently stick to your calorie deficit.

Further, you might have an overactive stress response. Chronic stress can make sticking to a calorie deficit more difficult for a number of reasons outlined here.

Given all of this, there are 3 areas you’ll need to focus on to lose weight when you have PCOS:

  • nutriton
  • exercise
  • behaviour


How To Lose Weight When You Have PCOS – NUTRITION

Your TDEE determines how many calories you need to maintain your current weight. You have to eat less calories than your TDEE to lose weight (a calorie deficit).

This applies to anyone, whether you have PCOS or not.

So, to lose weight when you have PCOS you must eat in a calorie deficit. 

It might be slightly lower than someone who doesn’t have PCOS but it will still work.

To work out what your calorie deficit should be, you first need to establish your TDEE.

You can follow this method to do this:

  • Track all the food you eat each day in a food diary app
  • Track your bodyweight each day
  • Do this for 2-3 weeks
  • For each week, add up your total daily calories consumed for the week and divide by 7
  • This is your average daily calorie intake
  • Do this for your body weight too to get your average body weight for each week
  • If your body weight has stayed fairly stable, then your daily calorie intake is your TDEE
  • Now you have your TDEE, to create a calorie deficit all you need to do is subtract 20%

For example, your starting TDEE might be 2500 calories. Your calorie deficit would then be 2500 x 20% = 500 calories.

Then, your total calorie target for weight loss would be 2500 – 500 = 2000 calories per day. 

You have to eat in a calorie deficit consistently for weeks to months to lose weight. 

Make sure you’re using more than just the scale to measure your progress too. You can learn more about measuring progress the right way here. 

You also want to eat enough protein.

To work out how much protein you need you can simply multiply your goal body weight in pounds by 1.

Say your goal body weight is 140 pounds. Your protein target would be 140g per day.

Protein has 4 calories per gram so that means protein will take up 560 calories of your daily calorie budget leaving 1440 calories for fat and carbs.

Now for someone without PCOS, I’d tell them that as long as they’re eating their minimum fat requirements, it doesn’t really matter how carbs and fats are divided up.

If you have PCOS and your insulin sensitivity is improved, this applies to you too. Aim to hit your protein and calorie targets and then divide carbs and fats up based on what makes you feel better.

However, if you have PCOS and insulin resistance, it can be helpful to eat a low carbohydrate diet for a period until your insulin resistance improves. This means most of your calorie budget should be spent on foods containing protein and fat with around 20% spent on carbohydrates.

In either case, you want to make sure your food is coming from whole food sources 80% of the time. It has been shown that including mostly low GI carbs and monounsaturated fats can be helpful in improving menstrual cycle problems and weight loss if you have PCOS.

Good sources of monounsaturated fats include: olive oil, avocado, almonds

Lower GI carb sources include: lentils, pasta, most vegetables, sweet potato.

It’s worthwhile to note that Vitamin D deficiency has been associated with some of the metabolic disturbances in PCOS and may exacerbate your symptoms. The best source of Vitamin D is sunshine. If this is difficult to get then you might want to talk to your doctor about a supplement. 


How To Lose Weight When You Have PCOS- EXERCISE 

Exercise is an important part of your plan to lose weight when you have PCOS. But it needs to be combined with changes in your diet because it will likely be ineffective on its own.

Doing some kind of moderate intensity aerobic activity daily will help improve your insulin sensitivity and your overall wellbeing. It will also increase your energy expenditure to help you lose weight. This doesn’t have to be hardcore cardio- a brisk walk is enough, especially if you also have an overactive stress response. 

Doing some kind of resistance training to help increase or prevent the loss of your lean body mass is also recommended. This will help you not only lose fat but also get healthier.

If you have PCOS, it’s likely that you’ll either have more muscle or be able to gain it relatively faster than a female without it. The key word is relatively– muscle will still take time to grow. Don’t be afraid to build muscle! As you lose body fat (from eating in a calorie deficit) more muscle will help create shape in the right places. 

In summary, you should aim to do 2-4 weight training workouts each week as well as some kind of aerobic activity daily.


How To Lose Weight When You Have PCOS- BEHAVIOUR

In order to lose weight and keep it off, you’ll have to work on changing your behaviour around food.

In the case of PCOS, you need to pay attention to your current eating habits and also how you deal with hunger and stress.

Behaviour changes and new eating habits take time to develop.

You need to start by identifying what behaviours have been holding you back from losing weight in the past. It’s probably going to be deeper than just overeating on the weekend. Why do you overeat on the weekend? Is it because you restrict yourself too much during the week? Or are you pressured by your friends?

You need to work this out for yourself and then come up with new habits to replace the old ones.

Then it comes down to doing the new habits consistently enough until they’re part of your life.

The tips below might help with some areas of difficulty if you want to lose weight when you have PCOS.

Controlling hunger:

  • Stick to a moderate calorie deficit (20%)
  • Make sure your meals are satisfying (lots of protein and choose slow digesting, low GI carbs)
  • Have regular meal times and stick to them
  • Go for a walk when you’re hungry to distract yourself until the next meal
  • Drink lots of water
  • Black coffee or tea and sparkling water can help to suppress appetite
  • If you’re really hungry, eat at your maintenance calories for the day

Controlling stress and emotional eating:

  • Don’t have trigger foods in the house
  • Find a low calorie food option that you like and have that as the only option to snack on
  • Have activities you turn to when you feel stressed that don’t involve food (meditation, doing some kind of deep breathing practise, going for a walk, having a bath, calling a friend etc)

Other behaviour changes:

  • Think about eating more protein and veggies rather than removing foods
  • Stop labelling food as good or bad
  • Quit the all or nothing thinking
  • Focus on other forms of progress than the scale (like being consistent)
  • Aim to integrate 1-2 small changes at a time
  • Once you’re consistent with those, aim to add some more


How To Lose Weight When You Have PCOS- SUMMARY

You should be able to see that there are legitimate metabolic reasons why it’s hard to lose weight when you have PCOS.

But you also shouldn’t use your PCOS as an excuse to not lose weight.

It’s possible and doing so will improve your health, your fertility and your quality of life.

Losing weight when you have PCOS ultimately comes down to making changes around your diet and activity that you can fit into your lifestyle and manage long term.

If you have any questions about your specific situation, you can contact me here. 



The Women’s Book- Lyle McDonald

A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome

Weight loss for women with and without polycystic ovary syndrome

Insulin and hyperandrogenism in women with polycystic ovary syndrome

Androgen (dihydrotestosterone) – mediated regulation of food intake

The role of vitamin D in polycystic ovary syndrome