10 Useful Tips To Lose Weight With PCOS & Why It’s So Hard 2023

Sara Chatfield

Updated on - Written by
Medically reviewed by Dr G. Michael DiLeo, MD

how to lose weight with pcos

Polycystic ovary syndrome, or PCOS, is a hormonal imbalance affecting about 5-10% of women of reproductive age[1]. Androgen hormone levels typically become elevated[2] and can cause irregular menstrual cycles, excess facial and body hair, skin changes, and ovarian growth[3]

Androgen excess can be either[4] a characteristic of PCOS or a trigger, and may be caused by anovulation rather than the other way around. PCOS–and its associated anovulation–causes infertility.

Experts suspect that PCOS originates from genetic causes or from insulin resistance associated with type 2 diabetes (T2D). The insulin resistance associated with PCOS heightens the risk of several chronic diseases, including obesity, T2D, cardiovascular disease, and some types of cancer[5]. Insulin resistance leads to high levels of circulating insulin[6], which increases levels of androgen hormones, worsening symptoms[7].

Read this article to know more about how to lose weight with PCOS.

10 Tips For Losing Weight With PCOS Naturally

  1. Watch your carbs
  2. Up your fiber intake
  3. Pay attention to protein
  4. Focus on healthy fats
  5. Avoid highly processed foods
  6. Eat to beat inflammation
  7. Aim for a healthy gut
  8. Up your activity
  9. Check your stress 
  10. Prioritize sleep

Why Is It Hard To Lose Weight With PCOS?

When you have PCOS, weight loss can be challenging for many reasons. 

The insulin resistance[8] common in PCOS causes weight gain, especially in the belly, which is a feature of metabolic syndrome[9], a cluster of conditions that increase the risk of cardiovascular disease and TD2. Insulin resistance also makes it harder to burn fat

Higher insulin levels can also increase appetite[3] and cravings for high-carbohydrate foods[8], making it harder to limit calories. Since excess weight further elevates insulin levels, this can lead to a vicious cycle of weight gain.

10 Helpful Tips For Losing Weight With PCOS

Weight loss[6] of even 5% of body weight can improve insulin resistance, androgen levels, and symptoms of PCOS. It can also help with infertility. Weight loss also reduces the risk of chronic diseases like diabetes and heart disease[10]

With the challenges the condition presents for managing weight, you may wonder how to lose weight with PCOS naturally. Read on for diet and lifestyle tips on losing weight, including how to lose belly fat with PCOS. 

Watch Your Carbs

how to lose weight with pcos

Too many quickly-digested carbs can worsen insulin resistance and contribute to weight gain in PCOS while limiting sugars and other refined carbohydrates can help.

Some studies[11] have found that low-carbohydrate diets led to significant weight loss, improved insulin sensitivity, and hormone levels, and lowered blood glucose and cholesterol levels. In women with PCOS, similar results should be expected.

Other studies[12] have found that low glycemic index (GI) diets positively affect PCOS. The glycemic index measures how quickly a food raises blood glucose. Low-GI diets’ benefits included lower waist circumference[5], a measure of abdominal fat, reduced insulin levels, improved cholesterol and triglyceride levels, and lower androgen levels[13].

Low-GI diets emphasize high-fiber whole foods that are more slowly absorbed, like fruits and vegetables, legumes, nuts, and whole grains. They limit quickly-digested carbs like sugars, white flour products, and white rice.

Up Your Fiber Intake

how to lose weight with pcos

High-fiber foods can benefit weight loss because they help fill you up with fewer calories. Eating more fiber can also improve insulin sensitivity[14].

Consuming more foods with soluble fiber has been linked to less abdominal fat[15]. One review[16] of studies found that adults who were overweight or obese and took soluble fiber supplements had significant decreases in body weight, body mass index, body fat, and insulin and glucose levels. 

Good sources of soluble fiber include beans, oats, fruits like apples, pears, and oranges, sweet potatoes, and some nuts and seeds. 

Prebiotic fibers may be particularly beneficial. Prebiotics are specialized soluble fibers that pass into the colon undigested and feed good gut bacteria. They’ve been associated with lower body weight[17], improved insulin resistance[18], and reduced cardiovascular inflammation[19]

Prebiotics are found in high amounts in certain plant foods like chicory, dandelion greens, onion, leeks, garlic, asparagus, chickpeas, bananas, and whole grains. 

Pay Attention To Protein

how to lose weight with pcos

Eating enough protein can help with feeling full and controlling blood glucose levels. Successful weight loss and maintenance require adequate protein intake. A higher protein intake (about 1.2 grams per kilogram) has been found to better maintain metabolic rate and muscle mass during weight loss[20].

A study[21] of 57 women with PCOS found that following a high (40%) protein diet for six months led to significantly more weight and body fat loss, lower waist circumference, and lower glucose levels than a standard (15% protein) diet. 

Good protein sources include eggs, lean meats, poultry, seafood, dairy products, beans, lentils, tofu, tempeh, seitan, nuts and nut butters, seeds, and quinoa. 

Focus On Healthy Fats

how to lose weight with pcos

Choosing healthy fats over saturated fats can help manage PCOS. High saturated fat intake from high-fat meats, dairy products, and processed foods can worsen inflammation, insulin resistance, and hormone imbalance in PCOS[22]

However, eating more healthful monounsaturated (MUFA) fats has been associated with lower levels of testosterone, an androgen hormone, in a study of women with and without PCOS[23]

Other studies have found that reduced intake of saturated fats and increased intake of healthful omega-3 fatty acids were linked with lower body fat, more balanced hormone levels, and higher HDL (good) cholesterol[24].

To up your intake of healthy fats, focus on foods high in MUFAs, like olive oil and nuts, and the omega-3s found in fatty fish like salmon, sardines, and mackerel. Plant sources of omega-3s include walnuts, soybeans, seaweed, and flax, chia, and hemp seeds. 

Avoid Highly Processed Foods

how to lose weight with pcos

Limiting highly processed foods, also termed ultra-processed foods, is critical when you have PCOS, particularly if you’re trying to lose weight. Weight loss requires limiting calories, and low-calorie diets have been linked with the most significant weight loss in studies of various diets for PCOS[25]

Manufacturers formulate highly processed foods like fast foods and pre-packaged snacks to be tasty and easy to eat, but they are typically high in calories. Consuming more ultra-processed foods has been found to increase calorie intake and weight gain[26]

Highly processed foods may also worsen insulin resistance[27] since they are typically high in added sugars and saturated fat. They’ve also been linked to increased inflammation[28] and lower levels of healthy gut bacteria[29]

Higher intake of ultra-processed foods has been associated with multiple chronic conditions, including metabolic syndrome, cardiovascular disease, type 2 diabetes[29], obesity, and cancer[30]

Eat To Beat Inflammation

how to lose weight with pcos

The metabolic and hormonal imbalances in PCOS can lead to chronic inflammation[1], raising the risk of chronic diseases like heart disease and diabetes. Anti-inflammatory eating patterns can reduce inflammation[31], improve insulin sensitivity and hormone levels, and help with weight loss.

In a study of women with and without PCOS, eating a diet higher in sugar and saturated fat and lower in fiber and healthy MUFA and omega-3 fats was linked to higher levels of inflammation, higher androgen levels, and more insulin resistance[32]

Mediterranean-style diets, on the other hand, can reduce inflammation. They’ve also been associated with lower body weight and better insulin sensitivity[33]. To follow a Mediterranean-style diet, emphasize fruits and vegetables, legumes, nuts, seeds, olive oil, and fatty fish, and limit saturated fats and added sugars.  

Aim For A Healthy Gut

how to lose weight with pcos

Women with PCOS tend to have lower levels of beneficial gut bacteria. This imbalance may promote inflammation, leading to insulin resistance[34]. Higher levels of good gut bacteria have been linked with improved insulin sensitivity and glucose levels[35].

Diets high in added sugars, animal products, and saturated fat have been associated with lower amounts of good gut bacteria than plant-based diets higher in fiber and nutrients[36]. Eating more high-fiber plant foods has been linked to increased beneficial gut bacteria and reduced inflammation. 

Prebiotics feed gut bacteria and may help with weight loss[17] and the management of PCOS. In one animal study, inulin (prebiotic) supplements improved markers of PCOS[34].

For a healthy gut, emphasize high-fiber, whole plant foods like fruits and veggies, legumes, whole grains, nuts, and seeds. Add prebiotic sources like dandelion greens, onion, leeks, garlic, asparagus, chickpeas, and bananas.

Up Your Activity

how to lose weight with pcos

Experts recommend about 250 minutes per week of moderate exercise, like brisk walking, or 120-150 minutes per week of vigorous exercise[37], like jogging, fast biking, or swimming, for weight loss.

Many women with PCOS don’t exercise due to fatigue or a lack of time[38], but increasing physical activity has many benefits for the condition. Studies[39] have found that vigorous aerobic exercise reduced body mass index and improved insulin resistance and androgen levels in participants with PCOS. 

It’s important to gradually work up to the physical activity, especially if you’ve been sedentary. Check in with your healthcare provider before starting any new exercise plan.

Check Your Stress 

how to lose weight with pcos

Women with PCOS are many times more likely to have symptoms of anxiety and depression than those without the condition[40]

Women with PCOS have been found to have high levels of stress, which are associated with anxiety and depression and can contribute to symptoms of PCOS. Levels of cortisol increase with stress; increased cortisol is associated with insulin resistance and higher glucose levels[41]. Chronic stress is related to increased abdominal fat[42] and metabolic syndrome.

Mindfulness techniques may help manage stress and symptoms of anxiety and depression in PCOS. Engaging in weekly mindfulness practices such as yoga and meditation[43] has been found to reduce stress and anxiety levels. 

One small study in women with PCOS found that an eight-week program of mindfulness stress management significantly lowered symptoms of stress, anxiety, depression, and measures of cortisol and increased quality of life in its participants[44]

Physical exercise has also demonstrated benefits for depression and anxiety[45].

It’s critical to consult with a provider for mental health care if you have ongoing symptoms of anxiety or depression. 

Prioritize Sleep

how to lose weight with pcos

Sleep disorders like sleep apnea, insomnia, and excessive daytime sleepiness[46] are much more common in PCOS. 

Anxiety, depression, stress, and the elevated cortisol levels that can occur with PCOS are linked to sleep disorders. Lifestyle factors like lack of physical activity and irregular eating patterns can also interfere with sleep[47].

A lack of sleep can increase appetite and cravings for high-calorie foods, adding challenges for weight loss. Too little sleep can also make it more difficult to lose body fat, even when limiting calories, and can negatively impact insulin sensitivity and glucose levels.

Sleep deprivation has been found to increase the risk of obesity, cardiovascular[48] disease, and type 2 diabetes[49]

Most adults need seven to eight hours of sleep per night[50]. Ensuring adequate physical activity, managing stress levels, and adhering to a regular sleep schedule–known as “sleep hygiene[51]” can help improve sleep. Avoid excessive amounts of caffeine, alcohol, and large meals, especially before bedtime, as these can interfere with sleep. 

If you suspect you have a sleep disorder, seek help from a healthcare provider for assessment and treatment.

The Bottom Line

The complexity of PCOS can make it difficult to manage. Women with PCOS can be burdened with multiple complications, including hormonal imbalances, menstrual cycle irregularities, infertility, insulin resistance, a higher risk of obesity and other chronic conditions, and bothersome cosmetic concerns like acne and unwanted hair growth. Losing weight is an important first step in managing the challenges of this complex syndrome.

Choosing a diet rich in whole plant foods with ample fiber, healthy fats, and adequate protein can improve satiety and gut health and help with weight loss, insulin sensitivity, and hormonal balance in PCOS. Other lifestyle factors like physical activity, sleep, and stress reduction can also assist with weight loss and symptom management. 

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Sara Chatfield

Written by:

Sara Chatfield, RDN

Medically reviewed by:

Michael DiLeo

I’m a Registered Dietitian Nutritionist with a Master in Public Health in Human Nutrition from the University of Michigan. I've worked in both clinical and public health settings, providing nutrition care to patients and clients with various health concerns. As a freelance writer I've created a variety of online content on nutrition and health, including nutrition courses for health professionals. My hope is to educate and inspire others to improve health through nutrition.

Medically reviewed by:

Michael DiLeo

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Database From National Institute for Occupational Safety & Health

U.S. Department of Health & Human Services
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Trusted Source

Database from U.S. National Library of Medicine

U.S. Federal Government
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Trusted Source

Database From Department of Health and Human Services

Governmental Authority
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PubMed Central

Database From National Institute Of Health

U.S National Library of Medicine
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