Losing weight with PCOS is harder for many women than for others, and that is not down to a lack of willpower. Insulin resistance makes your body hold on to fat around the belly more easily. The good news: even a weight loss of around 5% can improve your cycle and complaints (Teede et al., 2023).
I notice that women with PCOS often feel they are failing, while they are actually working against a biological headwind. That is an important difference. Below you read why losing weight works differently, what does seem to help and which blood values say something about it.
Why is losing weight harder with PCOS?
In PCOS insulin resistance often plays a part, a reduced sensitivity to insulin. Your body then makes more insulin, and high insulin stimulates the storage of fat, especially around the belly. So you lose weight less easily, even with the same effort as others.
On top of that, high insulin and hunger reinforce each other. You can get hungry faster, especially for fast sugars.
Factors that make losing weight harder with PCOS:
- High insulin that stimulates fat storage around the belly
- More cravings for sweets and quicker hunger
- Fatigue that makes exercise harder
- Hormones that keep each other in a vicious circle
How insulin fits into this circle exactly, you read in our article on PCOS and insulin resistance.
Why can a little weight loss already make a difference?
You do not have to lose much to notice an effect. Research shows that even around 5% weight loss can improve insulin sensitivity and make the cycle more regular (Teede et al., 2023). For someone of 80 kilos that is about 4 kilos.
That is because less belly fat can lower your insulin. A lower insulin can push the ovaries less towards testosterone, so ovulation starts more often.
The goal is therefore not a target weight from a table, but an improvement you notice in your cycle and energy. Small, sustainable steps seem to yield more than a strict diet you cannot keep up.
What does work in PCOS?
There is no separate PCOS diet that works for everyone. But the guidelines keep returning to the point that stabilising your blood sugar and regular exercise make the most difference (Teede et al., 2023). It is about a pattern you keep up for months, not a short course.
What research suggests can help:
- Food that keeps your blood sugar steadier, with fewer fast sugars
- Fibre-rich and protein-rich meals that keep you full longer
- Strength training alongside exercise for your fitness
- Enough sleep, because sleep shortage increases cravings and stress
These steps do not replace medical guidance. Some women also receive medication that supports insulin sensitivity. What suits you is something you discuss with your GP or a dietitian.
Which blood values give insight?
No single blood value controls your weight, but a few values show how your body handles sugar. With PCOS and weight you mainly look at your blood sugar over time and at your hormones. Together they give direction to what you can best focus on.
| What you want to know | Value that gives insight | What it shows |
|---|---|---|
| How your blood sugar holds up | HbA1c | Your average blood sugar over 2 to 3 months |
| Whether androgens play a part in your complaints | Testosterone and SHBG (in Hormones Women) | The degree of excess androgens |
The Diabetes panel measures your HbA1c and glucose among others. Want the hormonal picture alongside it, then the Hormones Women panel maps testosterone, SHBG and more. For the whole overview, read our PCOS pillar on symptoms, causes and diagnosis.
What if losing weight does not work?
Losing weight does not always succeed, and that does not have to be down to you. Hormones sometimes work stubbornly against you, and not every body responds the same. Importantly, health is more than a number on the scales.
Even without weight loss you can improve your insulin sensitivity and cycle with exercise and food. If it does not work despite your efforts, a conversation with your GP or a dietitian is sensible.
Discuss your situation with a doctor if you recognise this:
- You do not lose weight despite months of changes in food and exercise
- Your period stays away for months
- Alongside weight you also have fatigue or mood complaints
Frequently asked questions
Is there a special PCOS diet?
No, there is no diet that works for everyone. In many women it helps to keep your blood sugar steadier with fewer fast sugars and more fibre. A pattern you keep up works better than a strict course.
How much do I need to lose to notice a difference?
Even around 5% of your weight can improve your insulin sensitivity and cycle. For many women that is less than they expect. The goal is an improvement you notice, not a number from a table.
Why am I not losing weight while I eat healthily?
In PCOS insulin resistance can stimulate fat storage around the belly, which makes losing weight slower. That is not down to a lack of effort. A blood test and a conversation with your GP can help pin down the cause more sharply.
References
- Teede HJ, Tay CT, Laven J, et al. International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2023. Monash University, ESHRE and ASRM, 2023.
- Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-2855. PMID: 27664216.
- NHG and Thuisarts.nl. Polycystic ovary syndrome (PCOS). Dutch College of General Practitioners. Available via thuisarts.nl.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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