Reaching a healthy weight when you have PCOS

Reaching a healthy weight when you have PCOS

Women who have polycystic ovarian syndrome (PCOS) often struggle with their weight.  Doctors usually will mention weight loss to improve PCOS symptoms which is easier said than done. Weight gain and difficulty with weight loss seems to go hand-in-hand with PCOS.  Even though having PCOS makes it tough to lose weight, it doesn’t necessarily make it impossible.

What is PCOS?

PCOS is a hormonal imbalance and is the most common endocrine disorder in women of reproductive age.  PCOS was first recognized in 1935 and is associated with small cysts on the ovaries leading to hormonal imbalances.  Women with PCOS can also have insulin resistance increasing the risk for diabetes in addition to developing high blood cholesterol. 

PCOS affects nearly 7 percent of pre-menopausal women in the U.S. – that’s 1 in 5 women.  Girls as young as 11 years old can be diagnosed with it.  The cause is unknown but seems to run in families as women with a mother or sister with PCOS are more likely to develop it also.  The main issue is a hormonal imbalance where the ovaries are making more androgens (male hormones such as testosterone) than what normally a woman makes.  The high androgen levels can lead to various symptoms in women:

·      Weight gain

·      Acne

·      Excessive hair growth

·      Menstrual irregularities – infrequent, and/or absent

·      Infertility – PCOS is the most common cause of infertility in women

·      Cysts on the ovaries

·      Male-pattern baldness or thinning hair

·      Skin tags – excess flaps of skin in the armpits or neck area

·      Pelvic pain

·      Anxiety or depression

·      Sleep apnea

·      Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black

Why is PCOS linked to weight gain?

Up to 50 percent of women with PCOS are overweight or obese.  They tend to gain weight easily because they have higher-than-normal insulin levels – a hormone produce in the pancreas helping cells turn sugar (glucose) into energy.  This means more glucose or sugar gets stored as fat.  Another factor is some women with PCOS also have insulin resistance. This means that their body needs more insulin than normal to deal with sugar in the bloodstream.  High levels of insulin cause your body to store more fat and also causes the ovaries to make more testosterone, making the symptoms of PCOS worse.

Having PCOS coupled with weight gain promotes insulin resistance making it difficult to lose weight. The excess weight, particularly central obesity, makes infertility problems worse and increases risk for diabetes.  A weight loss of just 5 to 10 percent can improve PCOS.  This means if a woman weighs 210 lbs, a weight loss of 10.5 lbs can help bring improvements in lab results and menstrual cycles helping to increase the chance of fertility.

Eating plan for PCOS

Currently there has been no optimal diet composition identified for PCOS yet - but diet and lifestyle modifications are considered to be one of the first lines of defense in treating PCOS.  Therefore certain dietary modifications along with exercise can be used to help make a significant difference in women with this condition.  Here are some changes to try:

·      Eat more lean protein – Protein keeps a person feeling fuller longer reducing cravings for unhealthy snacks.  Lean protein such as chicken, fish, lean beef, eggs, or beans are very filling and a healthy dietary option. 

·      Eat anti-inflammatory foods – Inflammation is partly to blame for the hormone imbalance in PCOS.  Eating foods that help reduce inflammation can help minimize PCOS symptoms.  Include more tomatoes, kale, spinach, almonds and walnuts, olive oil, fruits (no fruit juice which is filled with sugar), fatty fish high in omega-3 fatty acids such as salmon, tuna, and sardines, and whole grains.

·      Reduce intake of refined carbohydrates – Overly processed foods – white bread, white rice, muffins, French fries, breakfast pastries, cake, cookies – cause inflammation and exacerbate insulin resistance which is problematic for women with PCOS.  By avoiding highly processed and sugary foods – including sugary beverages.  These foods have little to no fiber, antioxidants, or health-promoting nutrients.

·      Get a daily dose of vitamin D – Many women with PCOS have low vitamin D levels.  Correcting a vitamin D deficiency can help to improve insulin resistance.  The best food sources of this vitamin are egg yolks, milk, salmon, and sardines.  Otherwise, the very best source of vitamin D is the sun – try to be outdoors at least 3 times a week at midday for 10-20 minutes for maximum absorption of the sun’s rays.

·      Eat foods rich in omega-3’s – The advice on fats is to avoid saturated and trans fats while using more omega-3 rich foods and keeping total fat consumed under 35% of total calories. Omega-3 fats play an important role in helping PCOS.  They’ve been found to reduce LDL cholesterol, decrease insulin resistance and androgens in women with PCOS.  Foods containing omega-3 fats include walnuts, almonds, flaxseed, and fish like salmon, mackerel and tuna.

·      Limit dairy foods – Even though dairy foods are an excellent source of calcium, (women need 1,000 mg a day) research has shown dairy foods may affect fertility and acne.  Consuming 3 or more servings of milk may increase acne in some women - the acne was surprisingly increased more by drinking skim milk and not by whole milk.  At this time there is no formal advice on dairy but to limit dairy intake to two servings or less per day to reduce acne, androgens, and increased insulin.  Other nondairy foods to choose from containing good sources of calcium include cow’s milk alternatives (e.g., almond, hemp, rice, coconut), kale, broccoli, bok choy, fish like salmon and seeds such as chia, sesame and flax.

·      Make time for daily exercise – Regardless of a woman’s weight status, physical activity is an important component of treating PCOS for weight loss or maintaining a normal body weight.  Exercise can improve insulin sensitivity along with improving cholesterol levels.  Fertility can also be positively influenced by regular exercise as it helps in regulating menstrual cycles and ovulation rates.  Regular exercise also improves body mass index, waist circumference, and helps reduce androgen levels.

Take home message  

While there is no cure for PCOS, it can be greatly improved by making dietary changes and increasing exercise to help manage the symptoms.  If you are not certain if you have PCOS, check with your physician to see if you should get tested.  The sooner you know, the sooner you can start treating it, avoiding complications and leading a healthier life.