One of my specialities is nutrition for women with PCOS (polycystic ovarian syndrome). I’ve been specializing in PCOS for the past 7 years or so and have worked with hundreds of women with this condition.  I am writing this post because of the frustration I see with some of my patients with PCOS who are trying to lose weight. Up to 75% of women with PCOS are overweight. Losing weight is difficult enough for most people but it is often even more difficult for women with PCOS.

Why is it so difficult to lose weight if you have PCOS?  No one is 100% sure, but it  likely has something to do with insulin resistance and genetics. The majority of women with PCOS are insulin resistant. High levels of insulin can increase fat storage as well as increase hunger and carbs cravings (both of which can increase caloric intake).

Everyone has a different metabolism
In my experience,  most women with PCOS are able to lose weight with a lower glycemic index reduced calorie diet plan along with regular exercise. Not all overweight women experience difficulty losing weight. Some of my overweight patients with PCOS are able to lose 1-2 pounds a week by making changes in their eating and exercise habits. However, other women who have great difficulty losing even a pound on the same diet plan that easily promotes weight loss in other people. I know that this doesn’t  seem fair and I empathize with you. It is really difficult when you see other people eating a lot more than you are - and they are able to lose weight while your weight will not budge. This just goes to show that everyone’s metabolism is different.

But it is not impossible to lose weight! The majority of my patients are able to lose weight with diligence, consistency and patience with following the meal and exercise plan. It  may take longer for you than for some other women - but hang in there and you will eventually see results.

Here are tips for those women who are “slow losers” much difficulty losing weight:

1. Experiment with a very low calorie low carb diet for a few weeks to see if it will promote weight loss. I know that this plan can be very difficult to stick with on a long term basis, but it is likely that following it for a even a few weeks will help you drop several pounds. You can then follow a more moderate carb plan for a few weeks before going back on the more rigid plan. I will post several  ”stricter” meal plans within the next week or two as well as some dietary tips specific for women with PCOS.

2. Now when I say stricter, I don’t mean a starvation diet! Skipping meals or taking your calories too low will slow your metabolism.

2. Keep a detailed food log. You will need to weigh and measure some foods to make sure you are 100% on track with your calories. Most people underestimate what they eat by as much as 75%!

3. Make sure you are as active as you can possibly be. Walk as much as possible, engage in formal aerobic exercise at least 4 times a week for 45 minutes, take the stairs, walk instead of taking the subway, bus or driving (when possible). It would also be a good idea to add in light weight training.  Check out my post on Breaking Plateaus for more advice on increasing/changing activities.

4. Work with a physician who specializes in PCOS. Are you insulin resistant? Discuss this issue with your doctor. Most women with PCOS are insulin resistant (you still may be insulin resistant even if your insulin levels appear in the high range of “normal “on your blood test).  Metformin (glucophage) may be indicated as a medication that can lower insulin levels. The therapeutic dose is often ~ 2000 mg.  Keep in mind that metformin is not a diet pill and does not decrease the appetite or speed metabolism, so do not expect it to have a major effect on your weight. However  it can help reduce insulin levels which in a round about way can help to promote weight loss. It can also help reduce carb cravings. In addition, some women say it makes them feel a little nauseas so they do not want to eat as much. (Not a great way to lose weight, but if it helps you eat less and the nausea is not too bad… then I guess it is not the worst thing in the world!).

5.  Have you have your thyroid checked?

6. Make sure you are getting adequate sleep. Lack of sleep has been associated with an increased tendency for obesity.

7. Work on stress management as increased stress has also been associated with obesity.

8. Consider working with a therapist if you feel depressed, anxious, eat compulsively or have any emotions that you are having a difficult time dealing with on your own. Having PCOS and the symptoms that may go along with it can be very stressful for some women.

 9. Find a nutritionist who is knowledgable about PCOS. For those women who live in the NYC area, feel free to call me to set up an appointment (see my website below).

 For more information on PCOS and nutrition, check out the following:

My website (this contains useful links on PCOS)

Article I wrote on Diet and PCOS on Obgyn.net

Article I wrote on  PCOS and Nutrition from “Nutrition Today“

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