What you need to know about PCOS and weight gain

Why do so many women with PCOS also struggle with weight gain? Are they just not trying hard enough? Not restricting food enough? Not going to the gym enough?

Unfortunately, this is the narrative that I hear from so many of my PCOS clients who struggle with weight gain. And to make matters worse, this belief is affirmed at their doctor’s appointment when they have prescribed weight loss as the golden ticket to all their PCOS problems. It both saddens me and infuriates me when I hear these experiences, and yet it seems like the most common standard of care for women with PCOS.

If there is one thing I would want women with PCOS to hear,it would be “It is not your fault AND restrictive diets are not the answer.” PCOS comes with unique metabolic and hormonal challenges that require a unique approach when it comes to working towards a healthy weight. Traditional formulas based on “calories in calories out” just don’t work with PCOS. That is why understanding your PCOS, the root causes of your symptoms, and the strategies that address those root causes will be key to feeling your best with food and your body.

3 Unique Weight Challenges With PCOS

Insulin Resistance
Research shows that 65-70% of women with PCOS struggle with insulin resistance. Insulin resistance occurs when the body experiences chronically high blood sugar levels. The body then compensates by producing more insulin in order to help lower and maintain healthy blood sugar levels. However, over time, cells become less sensitive to elevated insulin levels which perpetuates excess insulin production and excess sugar in the blood, and because insulin is a storage hormone, it can drive the body’s preference to store energy rather than burn energy. This preference manifests as what women with PCOS call “stubborn weight.”

Disordered Eating
Did you know that women with PCOS are at higher risk for eating disorders and disordered eating behaviors than the general population? That is because PCOS symptoms such as extreme cravings, disruptive mood swings, and chronic weight fluctuations can create the perfect storm that drives binge-like eating and/or emotional eating behaviors. Many women with PCOS then attempt to gain control over these chaotic behaviors through restrictive and extreme diets. Unfortunately, these diets rarely work, and instead, amplify cravings, worsen mood, and perpetuate weight cycling.

Chronic Fatigue
If you experience PCOS, then you know chronic fatigue is REAL. Many women with PCOS report always waking up exhausted, relying heavily on caffeine to get through the day, and having trouble falling asleep and staying asleep when all they want to do is sleep! With chronic fatigue, even considering the idea of dragging yourself to the gym or spending hours on meal prepping can feel overwhelming and the last thing you want to prioritize. Then add on the weight of the self-judgment and internal dialogue of “Why can’t I just get it together?”, and you have a recipe for total burnout.

Weight As The Symptom, NOT The Problem.

As you can see, weight changes with PCOS don’t happen in isolation. Rather, they are an outcome of both physiological and psychological challenges than come with PCOS. That means if you’re not addressing your physiological and psychological needs, it will feel practically impossible to work towards your healthiest weight.

Losing Weight Without Losing Your Mind

Losing weight with PCOS does come with its unique challenges, AND it is 100% possible to create weight loss without having to cut out all your favorite foods, exercise 7x/week, and rely on willpower and self-control every minute of every day.

If you’re tired of spinning your wheels when it comes to losing weight with PCOS, I want to offer an alternative approach that is both mindful of protecting a healthy relationship with food and supporting your body to feel and function at its best. When it comes to weight loss, form follows function. A body that is operating well– aka experiencing minimum cravings, optimal sleep, and level moods will also look and appear well… and that’s great news! In fact, if your weight loss approach is creating MORE symptoms rather than reducing them, then it’s probably safe to say that it’s doing more harm than good.

Want a new approach to weight loss but don’t know where to start? Here are 3 strategies that you can implement today to start supporting your body in your PCOS Healing Journey.

1. Commit to getting off the diet roller coaster for good.
   If you’re still waffling between extreme diets and a free-for-all, the body will sense a lack of stability in its environment. This drives up stress hormones and creates “danger” in the body’s nervous system. Weight loss is incredibly challenging if not impossible when the body is in a chronically stressed state. Ditching the quick fixes and opting for an approach to nutrition that is doable, enjoyable, and sustainable is the first and essential step in this process.
   

2. Balance your blood sugar.
   I can’t emphasize this strategy enough. In fact, keeping your blood sugar balanced is going to be the through-line that guides you in making intentional and informed decisions with your meals. You can start balancing your blood sugar by pairing all carbs with protein, fat, and fiber as well as eating in a rhythmic manner. This will significantly reduce cravings and help you eat based on true appetite rather than blood sugar swings.
   

3. Address your stressors.
   Stressors can come in all shapes and sizes, and some stressors are not as obvious as others. Whether it be mental and emotional stressors like anxiety, perfectionism, or shame/guilt, environmental stressors like work, relationships, and pollutants, or physical stressors like nutrient deficiencies, sleep deprivation, or over-exertion, it is important to identify the unique stressors that you experience in your body and in your life. When the body is under chronic stress, it holds on to valuable energy stores “in case of emergency.” Lowering stress levels sends a signal to the body that it is safe and no longer has to resist weight loss.