Is It Harder To Lose Weight With Polycystic Ovary Syndrome?

Is it harder for women to lose weight? If you’ve heard a scoff of ‘of course, not!’, usually accompanied by a monologue on women just aren't working hard enough in the gym/not eating the right foods, you’re probably just as fed up as we are. The truth is, there are certain health conditions which can make it trickier to manage weight. This Polycystic Ovary Syndrome Awareness Month, we’re diving into one of the more taboo conversations that surrounds PCOS - how the condition can interplay with weight.

What is PCOS? 

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects nearly 1 in 10 women in the UK. One of the key features of PCOS can be difficulty managing weight. If you have PCOS, you might find that you struggle with weight gain, particularly around the midsection (e.g. tummy, hips, etc.), as well as challenges with losing weight through diet and exercise alone. 

What are the symptoms of PCOS?

There are three main signs or symptoms of PCOS: 

• Missed or irregular periods
• A high level of hormones called androgens (also known as “male” hormones)
• Polycystic ovaries (when small egg sacs on the ovaries fill with fluid)

You don’t need all three symptoms of PCOS to be diagnosed with it, typically doctors will diagnose you with PCOS if you’re experiencing two out of three of the symptoms with no other explanation for why you’re experiencing them. 

The Challenges of PCOS and Weight

Almost half the people with PCOS struggle with their weight, and there are a few reasons why PCOS can make weight management so difficult.

The hormone imbalances caused by PCOS, particularly high levels of insulin, can increase hunger and drive cravings for unhealthy foods. High quantities of the hormone androgen makes it more likely that weight gained by those with PCOS tends to accumulate around the midsection as belly fat.

PCOS is also linked to insulin resistance, which impairs the body's ability to use insulin effectively and can result in weight gain. Additionally, insulin resistance can lead to increased levels of the hormone leptin, which can disrupt the body's hunger signals and make it harder to control food intake.

Compounding the problem, many of those with PCOS also have issues with sleep quality, mood disorders like anxiety and depression, and other factors that can negatively impact metabolism and motivation for healthy habits. The frustration of trying and failing to lose weight, and feeling 'out of control' when it comes to food, can take a major toll on mental health and happiness. In fact, one study showed that women with PCOS are six times more likely to attempt disordered eating habits. We need to actively and openly address the hurdles associated with this condition - and support those who experience it with practical, sustainable habits.

Why Weight Loss Matters for PCOS

While losing weight isn't easy for anyone, it's both especially challenging and important for those with PCOS. Shedding excess pounds is key for managing PCOS symptoms and reducing associated health risks like type 2 diabetes, heart disease, and endometrial cancer.

Losing even a modest amount of weight (5-10% of body weight) can help:

• regulate the menstrual cycle
• improve ovulation
• enhance fertility
• boost the body's sensitivity to insulin

It can also provide relief from issues like hirsutism, acne, and hair loss.

A Multifaceted Approach to Weight Loss

So, science shows that weight loss can help relieve PCOS symptoms... and that this is simultaneously harder for those with PCOS to achieve. It might sound like an impossible solution, but ultimately, we need to take a multifaceted approach to weight loss which covers diet, exercise, stress management, and sometimes, pioneering medication. Here are some strategies that may help:

Diet and Exercise

A nutritious, calorie-controlled diet combined with regular exercise is the foundation for healthy weight loss. Look for eating plans that promote slow, steady weight loss through balanced nutrition rather than extreme calorie restriction. Emphasis should be placed on:

- Nutrient-dense whole foods like vegetables, fruits, lean proteins, and healthy fats

- Steady intake of fiber, protein, and healthy fats to promote satiety (feeling full!)

- Limiting intake of refined carbs, sugary foods/beverages, unhealthy fats

For exercise, both cardiovascular activity and strength training are important. Aim for at least 150 minutes per week of cardio and 2-3 strength sessions.

Strength Training

Don't just focus on cardio. Resistance training helps build metabolism-boosting muscle mass and can enhance insulin sensitivity. 

Stress Management  

High stress can worsen PCOS symptoms by increasing insulin resistance and appetite for unhealthy foods. Find healthy ways to keep stress in check, like yoga, meditation, counseling, or other mindfulness practices.

Weight Management Medication

The latest class of GLP-1 weight management medications taking the form of injections shows particular promise for people with PCOS who struggle to lose weight. Drugs like Mounjaro (tirzepatide) and Wegovy (semaglutide) act on hormones that regulate metabolism to suppress appetite and promote feelings of fullness. 

In clinical trials, these injectable medications have helped patients lose around 15-20% of their body weight on average when combined with lifestyle changes. For people with PCOS, this level of weight loss can make a meaningful difference in alleviating symptoms and reducing health risks.

If you have PCOS and have struggled with weight management, talk to your doctor about developing a comprehensive strategy that addresses nutrition, exercise, stress management, and possibly medication.

While PCOS may make losing weight more difficult, it's not impossible with the right personalised treatment approach for you.

Want more?

• Learn more about the weight management programme at HANX. Curious about how pricing works? Here's our guide.
• Facial hair, fertility and mental health: our in-house medical expert explains how to navigate PCOS side effects.