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Why Is It Hard to Lose Weight with PCOS

Overweight women with PCOS often struggle to lose weight. Even though you're following a diet, you're not seeing any improvement in you weight. Why so? Why is it hard to lose weight with PCOS?

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Posted on November 26, 2021 ·

It can be quite discouraging when you realise you don’t fit in your favourite pair of jeans anymore. Or when you don’t see the weight go down even after following a strict diet.  If you have polycystic ovary syndrome (PCOS) and are wondering how to lose weight with PCOS, you are not alone. 

Weight loss is often suggested as the first line of treatment to help reduce symptoms of PCOS. But those with this syndrome know it’s not that easy. So it’s important to not blame yourself for not losing weight,  but understand the root cause of what’s stopping you from losing weight. Here are reasons that explain why it’s so much harder to lose weight with PCOS.

Possible reasons why it is hard to lose weight with PCOS

There can be number of reasons that can make it difficult for you to lose weight with PCOS. Mainly it is the underlying hormonal imbalance that can make it difficult to lose weight.

Insulin resistance

70% of women who have PCOS have insulin resistance, which can lead to weight gain. Insulin is a hormone that transports glucose (your body’s main source of energy) from your bloodstream into your cells where it can be used as energy. PCOS affects your body’s release and use of insulin. Your cells stop responding to insulin, which is called insulin resistance, and this prompts your body to produce even more insulin.

Too much insulin promotes fat storage or weight gain, mostly in your midsection, resembling an apple shape. If you are gaining lots of weight or can’t lose weight without significant changes in diet or exercise routines, excess insulin could be the culprit. Overtime, if the blood glucose levels continue to stay elevated despite insulin production, it can lead to type 2 diabetes.

You can speak to your doctor for treatment options that are typically aimed at reducing insulin levels and involve diet modifications, exercise, and medications or supplements.

Imbalance in hunger hormones

Do you regularly get strong, intense, even urgent cravings? This could also be insulin’s doing! High levels of insulin could also explain why some people with PCOS experience more hunger. 

If not managed, these cravings can sabotage even the best eating habits, leading to higher calorie consumption and weight gain. Eating multiple small meals a day, increasing the protein content in your meals, and avoiding fried and sugary foods are all helpful ways to reduce cravings.

PCOS is a hormonal condition. But unfortunately, it affects more than just your reproductive hormones. Levels of appetite-regulating hormones such as ghrelin, cholecystokinin, and leptin have been shown to be impaired in women with PCOS. Imbalance of these hormones may cause   increased hunger in women with PCOS, resulting in increased food intake and difficulty managing weight.

Not following a PCOS diet

If you’ve been watching your diet and still aren’t seeing the kilograms come off, it could be the types of foods you are eating.

A study found that those with high insulin levels may be able to lose more weight following a low glycemic index diet. A low glycemic index diet involves eating foods that don’t spike up the sugar and insulin levels in your blood — for example, choosing complex carbohydrates like bajra and jowar, instead of simple carbohydrates like wheat and maida in your meals. 

Not eating enough fruits and vegetables can also impact weight loss. A study found that women with PCOS who followed the Dietary Approaches to Stop Hypertension (DASH) eating plan showed improvements in insulin resistance and abdominal fat loss. The DASH diet is a heart-healthy diet that recommends including plenty of fruits, vegetables, whole grains, low-fat dairy products while limiting high sodium, saturated fats and sugary foods.

Eating disorder

Since women with PCOS are often advised to follow a diet, some women develop eating disorders as a way to cope with the condition. Not just weight gain, but depression and negative body image associated with excess facial hair or acne may contribute to emotional eating. 

How does PCOS cause weight gain?

With PCOS, the underlying hormonal imbalance is the reason for all the symptoms. And weight gain is one of the most common symptoms of PCOS and many women struggle to lose weight. This is mainly because of insulin resistance which is the body’s inability to transport glucose in the cells. This leads to elevated levels of insulin in the blood and make it difficult to lose weight. Treating insulin resistance with lifestyle changes and in some cases medications can help with weight loss.

Risk-factors associated with PCOS-related weight gain

With or without PCOS – weight gain can increase the risk of developing many health complications in the future such as heart conditions and diabetes. And with PCOS specifically, weight gain can worsen insulin resistance and put you at a risk of developing type 2 diabetes. Also, if you are planning on getting pregnant, it is important to first lose weight as increased weight can also increase your risk of developing pregnancy complications.

Tips to Lose Weight With PCOS

A common question that a lot of people have is how to lose weight with PCOS. Losing weight requires a structured plan that is personalised to your symptoms and concerns.

Balance your diet

Following a balanced, nutritious diet is key in managing all the symptoms of PCOS. A diet that is rich in whole foods such as grains, fruits, vegetables, protein, fats and dietary fibre can help correct the hormonal imbalance. PCOS-friendly diet is about maintaining balance in everything you eat. And you don’t have to cut down on any food groups (except if you are intolerant) to see results. Every nutrient has a role and place in your daily diet.

Avoid processed foods and added sugars

Processed and packaged foods are rich in refined flour which has high glycemic index. This means that it can spike your blood glucose levels and can worsen insulin resistance. Although it is ok to occasionally indulge in foods that you like eating, it is best to limit  it and/or find healthier alternatives.

Keep inflammation under control

PCOS is associated with chronic level of low-grade inflammation. The inflammation is associated with many symptoms of PCOS such as headaches, GI issues, fatigue. By adding more anti-inflammatory foods you can reduce the levels of inflammation. Along with your diet, exercising regularly, managing stress and sleeping well can all reduce levels of inflammation.

Avoid undereating

Eating less or following a low calorie diet or eliminating certain food groups won’t help improve your symptoms despite the popular belief. You need to include all food groups in proportion as every nutrient has a role to play in your health. Calorie restriction or trying fad diets is not sustainable in the long-term. Many women have in fact experienced that their symptoms have worsened after trying fad diets. Visualise your diet as a way to nourish yourself instead of starving your body.

Exercise Regularly

Exercising regularly can help improve the many symptoms of PCOS and balance your hormone levels. Combining cardio along with strength training can help improve insulin sensitivity and lower androgen levels. You don’t have to spend countless hours in the gym, keeping your body moving with an activity you enjoy and also staying through the day can help improve PCOS in the long-run.

Get Enough Sleep

Whether you realise it or not, getting 7- 8 hours of quality sleep each night is important for your overall health. Sleep helps restore your cells and also reduce the levels of cortisol which is the stress hormone. Practicing good sleep hygiene such as maintaining a sleep schedule, turning off all electronic devices and practicing relaxation techniques can all help improve sleep quality.

Manage Your Stress

Your stress levels can have a negative effect on your PCOS treatment journey. The stress hormone, cortisol, can promote weight gain and can lead to eating disorders. Learning how to manage your stress with stress management techniques that will work for you can help you deal with stressful situations in the long-run. Meditation, journaling, breathing exercises, practicing mindfulness, can all be helpful.

Stay consistent

Weight loss is a journey and not something that will give you quick results. If you see certain weight loss plans that promise quick weight loss, remember that these are only marketing gimmicks. The key to losing weight is by staying consistent and trusting the process. Even if you don’t see visible changes on the scale, your body is burning fat and increasing muscle strength which will not only improve your overall health but also your PCOS symptoms.

Consider Supplements for Better PCOS Treatment

Although supplements are never a replacement for having a balanced diet – certain supplements can help manage the hormonal imbalance and help meet nutritional deficiencies. Supplements such as inositol, zinc, vitamin D, magnesium, iron, folic acid are some commonly used supplement that have shown to benefit women with PCOS. However, speak to a doctor before starting any supplement and to understand the required dosage.

 Weight Management with PCOS Medication

Even a small degree of weight loss will help improve your PCOS symptoms. Weight loss can restore the functioning of your ovaries and lead them to produce your hormones at normal levels. This can in turn lead to improvements in your PCOS symptoms, such as irregular periods, excess facial or body hair growth, acne, and scalp hair loss.

Although following a healthy lifestyle and making lifestyle modifications is the first line of treatment, certain medications prescribed for PCOS can help aid weight loss.

  1. Metformin, which is a commonly prescribed for type 2 diabetes is also prescribed for PCOS to reduce insulin resistance and testosterone levels. This can help regularise periods and also help with weight loss.
  2. However, there is no such evidence that weight loss medications are more effective than making lifestyle changes. If you are wanting to use weight-loss medications speak to your doctor first.
  3. The side effects, cost and sustainability of such medications should be assessed before using. Remember that taking medications is never a replacement for making lifestyle changes and should only be used in conjunction with a healthy lifestyle.

So ladies, now you know and understand how to lose weight with PCOS. If you need more personalised guidance on how to lose weight with PCOS, speak to our care managers, who can help you with a treatment plan that can help you lose weight and manage your PCOS symptoms in the long run! 

Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice, or as a substitute for medical advice given by a physician

Verified by Dr. Iris Lee

Fellow in Reproductive Endocrinology and Infertility, University of Pennsylvania

Dr. Lee is a fellow in reproductive endocrinology and infertility at the University of Pennsylvania. She completed medical school and residency training at the University of Pennsylvania as well. Her work focuses primarily on PCOS, particularly the metabolic and mental health implications. Outside of work, she enjoys baking, reading, and spending time with her husband and two puppies.

BY Team Veera

Medically Reviewed



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