Between 4 and 20% of reproductive-age women have polycystic ovarian syndrome (PCOS). Patients with PCOS often find it’s much harder to lose weight than it is for those without PCOS—and much easier to gain weight unintentionally. If you have PCOS and are trying to lose weight, you may feel frustrated that you’re doing everything “right” while the scale isn’t budging.

Family medicine physician Dr. Michelle Ayazo is certified by the American Board of Obesity Medicine and specializes in helping patients manage their weight. Because weight and PCOS are so interconnected, Dr. Ayazo emphasizes that patients need a whole-body approach to treat symptoms and see long-term results in the long term. Her goal is to help patients find personalized ways to make good health part of their lifestyle starting from their very first visit.

In this blog, Dr. Ayazo dives deep into how weight and PCOS are interconnected, how patients can manage both, and how a physician can help.

First, why is it so hard to lose weight with PCOS?

Polycystic ovarian syndrome (PCOS) is an endocrine disorder that affects hormones. Hormones are responsible for a lot of bodily processes that impact weight—including when we feel hungry, how our bodies use food for energy, our stress levels, and more.

Unfortunately, there’s a lot we don’t know about PCOS and all of the different ways this condition makes it harder to lose weight. Scientists are still studying the causes of PCOS and the best ways to treat it.

However, we do know that losing even a little weight has been shown to improve PCOS symptoms. To help on your journey to good health, Dr. Ayazo recommends following these steps for success.

Step 1. Be patient with your progress

Losing weight is challenging with PCOS, but not impossible. It may take you longer to lose weight than someone without hormonal imbalances. While slow progress can feel discouraging, a healthy lifestyle has benefits you may not notice right away.

Even if you don’t lose a significant amount of weight, healthy eating and exercise can reduce your risk of developing long-term health issues, like diabetes and heart disease. In conjunction with medication, a balanced diet and regular activity plan can also help improve some common complaints of PCOS, like heavy periods, acne, excess hair growth, and fertility problems.

Step 2. Exercise regularly

The official recommendation is that adults participate in at least 150 minutes of physical activity a week, which is about 30 minutes each weekday. Physical activity is important for all aspects of your health and wellbeing—including weight management.

Studies indicate that people with PCOS have a tougher time losing weight with exercise than people without PCOS. But, while weight loss may be slower, exercise still has powerful full-body benefits and can relieve many symptoms of PCOS.

If it’s hard to move more and sit less, try these tips:

• Find activities that you enjoy. Exercise doesn’t need to feel like a chore, and there isn’t one single exercise that’s the “best.” Instead, focus on activities that are fun to you, whether that’s playing a team sport, jogging with an audiobook, or hiking with friends on the weekend.
• Build a routine. Making physical activity a key part of your routine can turn it into a habit rather than a chore. Still, don’t stress about doing the same activity every day for the same length of time—allowing some flexibility into your routine can keep things from getting stale.
• Remember that even a little bit counts. Doing 5 or 10 minutes of activity is better than doing nothing at all. If you can’t get in your daily recommended 30 minutes, a quick walk or yoga break still has benefits over staying sedentary. Always take the opportunity to be active when you can.

Step 3. Balance your diet

There isn’t one diet that works for everyone. Instead, experts recommend people looking to lose weight focus on eating more protein, vegetables, and healthy fats while reducing sugars and carbs.

Many PCOS patients struggle with insulin resistance and elevated blood sugar, so making these changes can also reduce the risk of developing type 2 diabetes.

Here are some healthy eating tips:

• Eat protein and vegetables first. Eating protein and veggies before carbs can help lower your blood sugar more than eating carbs first. On their own, carbs can cause blood sugar to spike for a while—and then crash later on, which can lead to overeating.
• Cut back on carbs, but don’t cut them out entirely. There’s evidence that eating fewer carbs can help people with PCOS lose more weight and improve their metabolisms. Thankfully, low-carb doesn’t have to mean no-carb. In addition to eating protein and veggies first in a meal, switch to whole-wheat pastas and breads, which are good sources of dietary fiber and other nutrients.
• Find ways to cope with cravings. Many people with PCOS experience intense food cravings and face issues with binge eating. Cravings can often feel impossible to control, but there are ways to reduce them. A doctor or therapist can work with you to find ways to cope with urges to eat and help figure out what triggers your cravings.

P.S. Looking for something new to try? Check out our quick-and-easy recipe for baked salmon and veggies.

Step 4. Don’t over-restrict calories or over-exercise

Extreme diets and intense exercise sessions may seem like the path to quick results, especially if you’re frustrated with slow weight loss. But these “get slim fast” plans can actually cause more harm than good.

First, cutting out too many calories per day can put you at risk of nutritional deficiencies, which have whole-body health consequences. Research also confirms that extreme calorie-cutting ends with most people regaining weight, especially for those who return to poor eating habits.

Second, over-exercising can have negative consequences, too. One study showed that exercising without eating changes didn’t lead to as much weight loss as expected. Too much exercise can also put you at risk for injury, especially if you push yourself past your physical limits.

While healthy eating and regular exercise are essential for weight loss, take the slow and steady option to see long-lasting results.

Step 5. Consider medication

Though there isn’t a cure for PCOS, some medications can help manage symptoms. Medication often works best in combination with other lifestyle changes, like exercise and healthy eating. Some commonly prescribed medications include:

• Blood sugar medication. Patients with PCOS are often at a higher risk of developing prediabetes, which can turn into type 2 diabetes if left untreated. If your blood sugar is high, your doctor might recommend medication to help combat insulin resistance. Metformin is the most common medication for lowering blood sugar.
• Oral contraceptives (birth control). Oral contraceptive pills can help regulate hormones, which can reduce irregular periods and excess hair growth. They won’t cause weight loss, but the right birth control pill can be part of a robust treatment plan for managing PCOS.
• Weight management medication. The FDA has approved several different drugs to help people lose weight in combination with a healthy diet. Your doctor might recommend weight management medication if you haven’t had success with just diet and exercise alone.

Additionally, if your PCOS or weight contributes to feelings of depression or anxiety, your doctor may recommend seeking mental health help. While mental health treatment (such as seeing a therapist or taking antidepressants) won’t cause weight loss, it can help improve your overall quality of life and help you better cope with stress.

Final Step: Talk to a Doctor for Help

PCOS is a complex condition that affects everyone a little differently. Dr. Ayazo urges you to consult with your physician if you have PCOS and you’re struggling with weight or other symptoms.

As a family medicine physician, Dr. Ayazo aims to help each patient meet their individual health goals—including patients with PCOS who need personalized care. Tampa Bay patients can click here to schedule an appointment with Dr. Ayazo or call (813) 751-3700.

About Michelle Ayazo, MD

Dr. Michelle Ayazo is passionate about helping patients live their healthiest lives. As a board-certified family medicine provider, Dr. Ayazo specializes in Obesity Medicine, chronic disease management, functional medicine, and more.

Disclaimer: This blog is not intended to substitute professional medical advice. Every patient is different, so talk with your doctor to learn what treatment options are best for you.