The best nutrition for losing weight with PCOS

If you’re living with polycystic ovary syndrome (PCOS), it’s easy to feel trapped by your weight. Weight loss improves the symptoms of PCOS, like irregular periods. At the same time, PCOS makes weight loss feel impossible. It’s why up to 88% of women with the condition are also living with overweight or obesity.
Still, losing even a few pounds can lower your risk for other chronic health problems like diabetes, heart disease, and cancer. Here, the evidence-based strategies you need to lose weight, manage symptoms, and feel better in your body.

What is PCOS?

PCOS is a common health problem that impacts women and is caused by an imbalance of reproductive hormones. It is one of the leading causes of female infertility.

It’s also a diagnosis of exclusion. This means that other conditions must be ruled out first before PCOS can be diagnosed. This means it can take a long time to confirm a PCOS diagnosis, since other conditions that mimic PCOS signs and symptoms (like thyroid disease) must be explored and excluded first.

Once other conditions are excluded, you may be diagnosed with PCOS if two of the following criteria are met:

• You have irregular periods, including periods that come too often, not often enough, or not at all.
• You have signs of high androgen hormone levels, which include extra hair growth on your face, chin, and body, thinning scalp hair, or acne.
• You have higher than normal levels of androgen in the blood.

• You have multiple cysts on one or both ovaries.

PCOS can lead to lifelong complications, as well as other conditions, including anxiety, depression, eating disorders (particularly binge eating disorder), obesity, impaired fasting glucose, type 2 diabetes, non-alcoholic liver disease, cardiovascular disease, metabolic syndrome, obstructive sleep apnea, infertility, and endometrial cancer.

While the exact causes of PCOS are unknown, insulin resistance and inflammation appear to be involved.

What are the signs and symptoms of PCOS?

Individuals with PCOS may experience:

• Irregular menstrual cycles
• Excess facial and body hair (i.e., hirsutism)
• Acne on face, chest, and upper back
• Thinning hair or male pattern baldness
• Obesity, weight gain, and/or difficult losing weight,
• Small cysts on ovaries
• Insulin resistance
• Anxiety and depression
• Infertility or trouble conceiving
• Darkening of skin, typically in armpits, neck, and groin (called Acanthosis nigricans)
• Skin tags (small excess flaps of skin, typically in the armpits or neck area)
• Hunger soon after eating (about 1 hour after eating)
  
  

Can nutrition help with PCOS?

While there is no cure for PCOS, nutrition should be the first intervention for managing signs and symptoms, including insulin resistance, and to aid in weight loss for those with overweight or obesity. Making appropriate dietary changes can help individuals with PCOS achieve 5-10% weight loss, improve insulin sensitivity, and lower lipid levels. Nutrition can also help with controlling acne, managing excess hair growth, and regulating menstrual cycles.

How to follow a PCOS diet for weight loss

While there is no one “perfect” diet for PCOS, research shows that a number of dietary approaches including the DASH diet, the Mediterranean diet, and plant-based diets have been effective in managing PCOS-related symptoms. Something all of these dietary approaches have in common? They help minimize insulin spikes.

When we eat, the body breaks food down into glucose or sugar. In order to get glucose into cells for energy, however, the body needs the help of the hormone insulin. Many women with PCOS are less sensitive to the effects of insulin (called insulin resistance), meaning their bodies overcompensate by making more and more insulin, leading to spikes that can exacerbate PCOS symptoms. Nutrition, however, can help mitigate those spikes. Here’s how:

Fill up on fiber from fruits, vegetables, and complex carbohydrates

Fiber is a specific type of carbohydrate that passes through the digestive tract mostly undigested. Carbohydrates that contain fiber are often referred to as complex carbohydrates, while carbohydrates that lack fiber are often referred to as simple carbohydrates.

Unlike simple carbohydrates, complex carbohydrates have a stabilizing effect on blood sugar and insulin levels, and even support a healthy gut microbiome, which may improve PCOS symptoms.

Not only does fiber slow how quickly we digest our food, it also adds volume to our meals, helping us to get and stay fuller for longer. As a result, adding more fiber to your diet can help you to eat less food overall.

If you’re like most women with PCOS, though, you may not be getting the recommended 25-30 grams per day. You can boost your fiber intake by eating more non-starchy vegetables like asparagus or broccoli, beans, legumes, lentils, sweet potatoes, whole grains, fruit, berries, artichokes, avocados, oats, and almonds. Focusing on fiber-rich foods that you enjoy (versus forcing foods you dislike) is a great way to increase your intake.

Beyond fiber, fruits and vegetables are rich in phytochemicals, which are plant compounds that also assist in insulin sensitivity. Aiming for around two cups of non-starchy vegetables (or 1 ⁄ 2 of your plate) at lunch and dinner is a great starting point for increasing your intake of these foods.

Eat protein at every meal and snack

Protein helps you feel fuller and more satisfied at meals and snacks, and it also helps slow down the absorption of sugar into the blood.

Current dietary guidelines call for just 0.36 grams of protein per pound of body weight per day, which is 72 grams for a person who weighs 200 pounds. But several clinical trials have found that protein intakes higher than the recommended daily allowance are optimal for weight loss in adults with obesity.

There aren’t many studies that have looked at high-protein diets for weight loss with PCOS, specifically. But in general for weight loss, we recommend consuming at least 1 to 1.5 grams of protein per kilogram of body weight. That’s about 90-135 grams of protein for a 200 pound person.

Lean protein is key here. Some high-protein foods also come with a lot of fat, which means excess calories, so we recommend leaner protein options. This includes skinless poultry, fish, lean beef and pork, tofu, beans, non-fat and low-fat dairy such as Greek yogurt and cottage cheese, eggs, nuts, and seeds. To get enough protein, we recommend eating these at most meals and snacks. For most individuals, aiming for a minimum of 30-40 grams of protein with meals and 10-15 grams of protein with snacks is a good starting point.

Limit added sugar and processed carbohydrates

Sugary foods and drinks increase blood glucose levels more rapidly than other foods, which can lead to more insulin production.

Limiting added sugars will help keep your blood sugar and insulin levels from spiking too much. Plus, limiting these will help cut out low-nutrient calories in the process, further aiding in weight loss.

The American Heart Association recommends limiting added sugars to about 25 grams per day (which is about 100 calories from added sugar), for the average female. This will help with weight loss while also supporting overall health.

Some examples of simple swaps for reducing your intake of added sugars include:

• Choosing a piece of fruit or adding a splash of fruit juice to sparkling water instead of drinking juice

• Swapping store bought dressings for homemade vinaigrettes

• Opting for homemade snacks that are rich in fiber and complex carbohydrates

• Opting for zero calorie beverages (such as water, sparkling water, unsweetened beverages and diet drinks) instead of sugar-sweetened beverages (like juice, sweetened iced teas and coffees, and regular soda)

Don’t cut carbohydrates, just keep them consistent

Spreading your carb intake evenly throughout the day facilitates weight loss by keeping your blood sugar and insulin levels relatively steady, and by preventing cravings or increased hunger from blood sugar swings. The secret to reducing your carb cravings isn’t to eliminate carbs, but rather to focus on fiber-rich versions and incorporate them consistently throughout your day.

Just as foods higher in sugar can lead to larger blood sugar spikes, so can eating a lot of carbs in one sitting — even if they’re healthy carbs like fruit and whole grains.

This might happen if, for example, you avoid carbs for breakfast and lunch but consume a large serving of them at dinner. Or if you eat a carbohydrate-rich breakfast and stick to protein and fat for the rest of your meals.

A good rule of thumb is to stick with a small-to-moderate portion (or about 1 cup or 1 fistful) of complex carbohydrates at each meal, rather than eating large portions of carbs sporadically throughout the day.

Focus on heart-healthy fats

Research suggests that individuals with PCOS may have a different reaction to saturated fats than individuals without PCOS, and that the consumption of saturated fats may worsen inflammation in women with PCOS. This effect may be even greater in women with PCOS who also have obesity.

While this research is still emerging, there is strong evidence that suggests the consumption of heart-healthy fats, particularly omega-3 fatty acids, have a beneficial effect on PCOS symptoms, as well as generally supporting other areas of health, such as heart health. Omega-3 fatty acids — a particular type of polyunsaturated fat — reduce pro-inflammatory proteins, increase insulin sensitivity, and reduce the body’s creation of LDL (the “bad”) cholesterol. In one study, supplementation of omega-3 fatty acids for six months decreased lipid profiles and waist circumference in women with PCOS.

Consuming two 4-ounce servings of fatty fish (like salmon, trout, or tuna) per week is enough to meet your omega-3 needs. Sea algae and algal oil are also great sources for vegans, vegetarians, or individuals who are allergic to fish. Other plant forms of omega-3 fatty acids (like ground flaxseeds or flaxseed oil, chia seeds, hemp seeds, or walnuts) are also good plant-based omega-3 options, but these are harder to convert to the form that is most biologically available to the body, so more of them is often needed.

Other heart-healthy fats beyond those that are rich in omega-3 fatty acids include avocados, olive oil, nuts, and seeds.

Be mindful of alcohol

A number of studies have suggested that alcohol may impact how the body processes the hormone estrogen and may lead to increased estrogen levels. Women with PCOS may experience imbalances in the ratio of the hormones estrogen to progesterone, and research suggests that alcohol intake may further aggravate this imbalance. Moreover, alcohol also interferes with blood sugar levels. Moderate amounts of alcohol can increase blood sugar, while excessive amounts can have the opposite effect and lead to abnormally low blood sugar levels.

Since many women with PCOS have insulin resistance, alcohol consumption can worsen the condition. If you have PCOS and enjoy alcohol, do so in moderation and be sure to consume it with a balanced meal that has plenty of protein, fiber, and healthy fats. What is considered moderate? A moderate amount of alcohol is around 1 drink per day for women. As always, consult with your physician for individualized medical advice.

Lifestyle changes beyond diet

Move Your Body

Exercise can support weight loss by increasing your daily calorie burn. But there’s another reason why those with PCOS who want to lose weight should work out more: Insulin.

Your muscles need energy to fuel your workouts. And exercise makes your body more sensitive to the effects of insulin, allowing your muscles to pull more glucose or sugar from the blood into the cells for energy.

The insulin-sensitizing benefits of exercise appear to last long after your workout ends. By some estimates, your body uses insulin more effectively for 16 hours or more after intense exercise.

If you don’t already work out, build up to at least 150 minutes of moderate-intensity aerobic exercise per week. For best results, you’ll also want to incorporate at least two resistance training sessions per week. Resistance training has the additional benefit of helping you maintain more lean muscle mass during your weight-loss journey, so it’s a win-win.

Prioritize self-care

Sleep, stress management, and social support are also essential for women with PCOS. Evidence suggests that the synthesis of melatonin — a hormone our body releases when it’s time to wind down — may be reduced in women with PCOS, and that sleep disorders can intensify the pathways associated with insulin resistance. Aim for a minimum of 7-8 hours per night.

Stress may also worsen PCOS symptoms. It stimulates the adrenal glands, which may contribute to already increased levels of androgens in the body. Stress can also contribute to anxiety and depression, which are common conditions for women with PCOS. Setting boundaries, prioritizing your mental and physical health, and staying connected to loved ones can improve PCOS symptoms and overall quality of life.

Medications may help

A handful of studies have linked PCOS with hormone imbalances that can increase food cravings and hunger levels while decreasing satisfaction after meals. Medications like GLP-1s can help lower the appetite and reduce food cravings, making weight loss easier and more attainable for those with PCOS.

The bottom line

The hormone changes that occur with PCOS can make weight loss feel even more overwhelming and challenging. Focusing on nutrient-rich foods — packed with protein, fiber, complex carbs, and healthy fats — can go a long way toward managing symptoms and promoting weight loss. Moving your body and prioritizing self-care can also help, as can certain medications like GLP-1s. All of this is made easier, however, when you’re not doing it alone. WeightWatchers offers powerful weight-loss solutions for women living with PCOS, including access to clinicians, dietitians, trainers, and an empathetic community to boot.

This content is for informational purposes only and does not constitute medical advice, diagnosis or treatment. It should not be regarded as a substitute for guidance from your healthcare provider.