How To Lose Weight When You Have PCOS: 8 Science-Backed Tips

PCOS (polycystic ovary syndrome) is a common hormonal disorder that affects up to 20% of pre-menopausal women.

The exact cause is unknown, but an imbalance of male sex hormones (called androgens) is a big culprit.

One of the most common symptoms is weight gain. In fact, 39% of women with PCOS are overweight or obese (1).

Fortunately, a few lifestyle changes can help you to balance hormones and lose weight.

This article looks at 8 tips for losing weight when you have PCOS.

1. Choose a Diet that Lowers Insulin

Both PCOS and weight gain lead to insulin resistance.

Insulin resistance then increases production of androgens, which leads to additional weight gain. This forms a stubborn feedback loop (2, 3, 4).

PCOS INSULIN RESISTANCE CYCLE

Therefore any diet that reduces body weight and insulin levels will help. In fact, even modest weight loss will help lower insulin resistance in PCOS (5, 6).

That means low fat and vegetarian diets can work, as can Paleo and Mediterranean. Anything that you enjoy and can stick to long-term, really.

There are certain eating patterns that have been specifically studied for PCOS too:

Low Carb Diets

Low carb diet

A low carb diet is an eating pattern that consists of about 30% of energy from carbs.

For comparison, a standard American diet is around 55-65% carbs.

Low carb diets have been shown to decrease insulin resistance particularly well. In theory, this should help prevent a rise in androgens that contribute to weight gain in PCOS (6, 7).

Additionally, low carb diets tend to be high in protein as the carbs must be replaced by something. High protein diets help curb appetite, leading to a lower calorie intake throughout the day and more weight loss (8).

Ketogenic Diets

Ketogenic diets are very low in carbs (about 5% of total energy), moderate protein, and very high in fat.

They have also been shown to lower insulin levels and burn body fat. In theory then, they should be helpful in PCOS (9, 10).

In a small study of 5 women with PCOS, a 24-week ketogenic diet reduced their body weight by 12%, testosterone by 22%, and fasting insulin by 54% on average (29).

However, that diet restricted participants to a maximum of 20 grams of carbohydrate per day for the entire 24 weeks. That’s equal to 1 large piece of fruit or just over one slice of bread per day. The rest of their food had to be pure fat or protein.

Obviously this is not sustainable for the vast majority of people, which is why I don’t recommend it.

In fact, 11 women started that study yet only 5 managed to complete it.

Summary: Any diet that reduces both weight and insulin levels is helpful in PCOS. Low carb diets appear useful and are backed by early studies.

2. Limit Junk Food and Avoid Binge Eating

limit junk food for PCOS

There is little room for junk food in a weight loss diet.

Chips, candy, sweetened beverages and other foods high in calories and added sugars offer no nutritional benefit.

Added sugars in particular increase insulin resistance and can contribute to weight gain in the context of excess calories (11).

Additionally, junk foods can also trigger binge eating episodes in some women. Especially when you’re stressed or emotional (12, 13).

In one study, 60% of obese women with PCOS displayed binge eating behaviors (14).

It is not known exactly why women with PCOS are prone to binges. But the hormone ghrelin, which regulates hunger and fullness, may be involved.

Typically ghrelin levels fall within an hour of finishing a meal, helping you feel full and satisfied

However, women with PCOS tend to have a slower decline in ghrelin levels after meals. This same pattern is also observed in women with binge eating disorders (15, 16, 17).

Limit your added sugar intake by keeping junk foods out of the house or in inconvenient places. This will make you less likely to binge eat too.

Summary: Junk foods are high in calories and added sugar, which promotes insulin resistance. They can also encourage binge eating, which seems to be more common in women with PCOS.

3. Exercise Regularly

Young woman doing exercise

Diet is easily the main priority in PCOS. 

Even those who exercise regularly can gain weight with a poor diet (18).

But exercise has many other benefits of course, especially for women with PCOS.

Resistance training (also called strength training) is particularly helpful for reducing abdominal fat and improving insulin resistance (19).

This includes weight lifting, as well as body weight exercises.

In one recent study, women with PCOS who performed resistance training exercises 3 times per week for 4 months showed significant improvements in waist circumference and lean muscle mass (20).

Increased muscle mass leads to an increased metabolic rate. That is, the amount of calories you burn when at rest.

Cardiovascular exercise is still important mind you, and it actually boosts the effects of strength training.

Walking at least 7500 steps per day has been shown to reduce BMI (body mass index), waist size, and androgen levels in women with PCOS (21).

Speak with your doctor before beginning a new exercise routine.

Summary: Exercise – especially weight training – is effective in reducing body fat, insulin, and androgen levels in PCOS. A program that combines weight training with a bit of cardio is ideal.

4. Measure Your Portions

Portion distortion is a major contributor to weight gain (25).

Measuring portions is one way to ensure that you don’t overeat. It shouldn’t be done forever, but at least for a few days to give you a base understanding.

Packaged foods include the suggested serving size on the nutrition label. Be sure to measure out a proper portion using a food scale or measuring cups or spoons.

Alternatively, use your hand as a guide if you’re eating a food without a label.

Hand portion guide for food servings

Summary: It can be easy to overeat without realizing it. Understanding and controlling portion size is a good way to prevent this.

5. Practice Mindfulness

Mindfulness is a form of meditation that trains the mind to be more present and focused.

It’s been shown to reduce stress-related overeating and increase recognition of hunger and satiety signals (26, 27).

Thus, it may be helpful in controlling body weight.

Mindfulness is safe and can be learned at home. Many free resources are available online.

The website Headspace offers 10 free guided sessions and an app for on-the-go mindfulness training.

Summary: Mindfulness may be a useful strategy for weight loss as it helps you to focus and be more aware of your eating habits. It can be used in addition to the diet and exercise recommendations.

6. Drink More Water

Drink More Water

Drinking more water has been shown to help with weight loss (28). 

Even mild dehydration brings on symptoms that could be confused for hunger, such as fatigue and dizziness.

Additionally, replacing sugar-sweetened beverages (like sodas or fruit juice) is an easy swap that cuts out a huge amount of calories.

Choose unsweetened still or sparkling water as your go-to beverage.

Summary: Replacing sugary beverages with water prevents dehydration, reduces calorie intake and may be helpful for weight loss.

7. Certain Medications Can Help

Diet and lifestyle changes are fundamental to managing PCOS.

In some cases, where these methods are unsuccessful, doctors may prescribe medications to help.

Metformin is a diabetes drug commonly prescribed for PCOS too. It helps the body to use insulin more effectively.

See your doctor if you are having trouble losing weight with the suggestions in this article.

Summary: If you are unable to lose weight with diet changes and exercise, see your doctor. Medications may help.

8. Chromium Supplementation May Help, But I Doubt It

Woman holding pile of pills in cupped hands, close-up

Chromium (III) picolinate is a supplement derived from the metallic element chromium.

Many natural health websites report it helps the body use insulin more effectively. And now some small studies have explored its effects on patients with PCOS.

One study found 200 micrograms per day for 8 weeks improved insulin resistance. Another found that 1000 micrograms per day of chromium(III) picolinate for 6 months greatly improved BMI and insulin resistance (22, 23).

However, larger studies looking at diabetics (rather than women with PCOS) indicate chromium does not improve insulin action (24).

Additionally, chromium may also interact with medications, which could be dangerous.

Based on the weight of evidence, you could try it but I’m not convinced it will be all that useful. In the end, quick fixes like supplements are never the solution.

Summary: Small studies and internet reports suggest that chromium supplementation helps with PCOS. But larger, albeit less relevant studies suggest it’s ineffective and can potentially interact with other medications.

Sample Meal Plan for PCOS

Genoa Salad with Tuna

This is a sample meal plan designed for weight loss when you have PCOS.

It’s based on the recommendations described earlier in this article.

Overall, it’s lower in carbs (30-50%) than the standard American diet.

Monday

  • Breakfast: Eggs and spinach.
  • Lunch: Tuna salad with olive oil, and a handful of nuts.
  • Dinner: Ground beef and lentils with veggies and full fat Greek yogurt. Make enough to have for lunch tomorrow.

Tuesday

  • Breakfast: Small bowl of oats.
  • Lunch: Leftovers from previous night.
  • Dinner: Chicken stir-fry with broccoli and asparagus. Make extra for lunch tomorrow.

Wednesday

  • Breakfast: Full-fat Greek yogurt and berries.
  • Lunch: Leftover stir-fry from previous dinner.
  • Dinner: Cheesy potato, cauliflower and broccoli bake (gratin). Make extra for lunch tomorrow.

Thursday

  • Breakfast: Eggs and spinach.
  • Lunch: Leftovers from previous dinner plus 1 orange.
  • Dinner: Salmon with broccoli and asparagus in cream.

Friday

  • Breakfast: Small bowl of oats.
  • Lunch: Tuna salad with olive oil, and a handful of nuts.
  • Dinner: Steak and roast veggies.

Saturday

  • Breakfast: Full-fat Greek yogurt and berries.
  • Lunch: Chicken avocado salad with olive oil and 1 apple.
  • Dinner: Dine out.

Sunday

  • Breakfast: Sausages and egg with avocado.
  • Lunch: Cucumber and carrot sticks with quark, and a handful of nuts.
  • Dinner: Tempeh stir-fry with lentils, cashew nuts and green leafy veggies.

Snacking should be strictly limited. Choose 1 piece of fruit.

More ideas for low carb meals can be found here.

The Punch Line

Weight loss with PCOS is extra challenging because of insulin resistance and imbalanced sex hormones.

However, it’s certainly possible and diet remains the most important factor.

Reducing carbohydrate intake is particularly helpful, especially from high calorie junk foods that contain added sugar. Resistance exercise to build muscle mass alongside several other lifestyle modifications can also help dramatically.

It’s not easy, but it can be done.

 

Avatar

About Kimberly Yawitz (Registered Dietitian Nutritionist)

Kim Yawitz is a registered dietitian and nutritionist in St. Louis, Missouri.

She currently works with sports nutrition and weight management clients for a private practice. Prior to that Kim worked as an inpatient clinical dietitian, developing nutrition care plans for patients with health concerns ranging from autoimmune disease to critical illness.

Learn more about her on the About page