By Kym Campbell, BSc. | Updated September 15th, 2022
PCOS affects between 4-20% of women worldwide. More than half of these women are classified as overweight . The best diet for PCOS weight loss addresses the two primary mechanisms that cause PCOS weight gain. Chronic inflammation and insulin resistance.
This is why women see such great results during my free 30-Day PCOS Diet Challenge.
In this article, I share nine evidence-based tips that define the best diet for PCOS weight loss. For help putting these ideas into practice, you can download this accompanying free 3-Day Meal Plan.
Knowing which foods to eat with PCOS is a big part of the battle. That’s why I’ve also prepared this PCOS Diet Cheat. This one-page printout contains over 180 PCOS-friendly foods and drinks.
1. Restricting Calories Isn’t the Answer
Many people mistakenly think that restricting calories is key to PCOS weight loss. Yet, studies show that for the majority of people, caloric restriction leads to weight gain over the long term .
The calories in vs calories out model of weight loss isn’t helpful. It’s an oversimplification of a complex problem that creates “failed dieters”.
The reality is that PCOS women gain weight easier than other people . This isn’t because they eat too much, or don’t get enough exercise. Studies show that this hypothesis is wrong . It’s because of inflammation and poor insulin regulation [4-10]. When it comes to diet, what you eat is much more important than your caloric intake.
This is what I show people during my free 30-Day PCOS Diet Challenge. You can eat until you’re comfortably full and still lose weight with PCOS.
“I don’t count calories/macros or account for what I’ve eaten because I’m now able to pay attention to the cues my body sends me in terms of when I’m hungry, when I’m full, and when something bothers me.” LeeAnne Soule. Lost 65 Lbs and fixed her period.
Rather than focusing on how much you eat, here’s what you need to do instead. If you want to know the best way to lose weight with PCOS follow these steps.
2. Manage Your Blood Sugar Levels
The reason that the majority of women with PCOS are overweight is because of insulin resistance. This is a condition where your insulin levels remain high for too long. Insulin causes body fat storage.
Insulin levels rise in response to your blood sugar levels. The best way to prevent elevated insulin is to keep your blood sugar levels low too.
Most doctors will tell you that a peak blood sugar level below 140 mg/dL (7.8 mmol/L) is within normal ranges. But if you’re consistently hitting this level, then you won’t lose weight. Even if you’re heavily restricting calories.
Women with PCOS that want to lose weight need to keep their post-meal blood sugar levels below 110 mg/dL (6.1 mmol/L).
Optimal fasting levels should be between 72 – 85 mg/dL (4.0 – 4.7 mmol/L). This is significantly lower than standard recommendations of < 99 mg/dL (5.5 mmol/L). The best way to achieve good blood glucose levels is by following the steps below.
3. Get Your Macros Right
Macros are the new calories for weight loss. The idea here is that the relative proportion of macronutrients in your diet is key to managing body weight. This is because macros influence blood sugar levels. Over time, that means lower insulin and less body fat.
The USDA recommends the following macros for the average adult : 10-35% protein, 20-35% fat, 45–65% carbohydrate.
For women with PCOS, this macro balance is likely to cause weight gain.
I recommend a diet that’s roughly 20% protein, 60% fat, and 20% carbohydrate. This is low-carb by most standards, but not ketogenic. As I explain here, I don’t recommend the keto diet for PCOS.
I provide a full accounting of macros for PCOS here. The key take home is that the best way to lose weight with PCOS is to eat more fat and fewer carbs. Doing so improves insulin regulation which leads to a reduction in body fat.
The balance of macros is more important than how many calories you consume.
4. Limit Carbs
For most people, getting your macros right means reducing sugar intake. Bringing your sugar intake down as low as is reasonably practical is the most important step for losing weight with PCOS.
Modifying your intake of other carb-rich foods is also key. You want to eat slow-carb and low-carb, from whole food sources. This means black rice, quinoa, beans, and starchy vegetables are all fine to enjoy. But you want to limit serving sizes to around 25 grams of net carbohydrates per meal.
You’ll find this amount of carbs in:
- ½ cup of cooked rice or quinoa
- ¾ – 1 cup of cooked beans or lentils
- A medium-sized sweet potato
- 2 ½ cups of starchy vegetables such as carrots, beetroot, butternut, or acorn squash
- 1 cup or 1 medium-sized piece of fruit
The recipes I share in my free 30-Day PCOS Diet Challenge follow these guidelines.
Other carb-rich foods are likely to make weight loss harder. This is especially true if the foods have a high glycemic index. Pasta, bread, snacks, and cereals are the worst offenders within this group.
5. Make Peace with Fat
The flip side of a low-carb PCOS diet, is you need to eat more fat. This can be scary for women that dieted a lot in the past.
This fear is often driven by decades of misinformation promoted by health authorities. Saturated fats have had a particularly hard time in the past. But the weight of evidence now shows that saturated fat doesn’t increase heart disease risks . Experts argue that the US Dietary Guidelines recommendation to limit saturated fats, ‘lacks scientific rigor .’
From a practical perspective, you only need to look at the success of ketogenic diets for driving weight loss. I don’t support the use of a keto diet for PCOS. But it shows how dietary fat doesn’t make you fat.
There’s other compelling evidence showing that the right kinds of fats improve weight loss:
- Fat consumption has a positive effect on satiety and appetite .
- Some of the fats found in beef and lamb increase insulin sensitivity [22, 23], and reduce body fat [24, 25].
- Coconut products contain medium-chain triglycerides. These fats promote fat loss from the stomach and thigh areas [26, 27].
6. Eat More Meat, Fish, & Eggs
Getting more protein also helps with PCOS weight loss. According to an article published in the American Journal of Clinical Nutrition , dietary protein:
- Increases satiety to a greater extent than carbohydrate or fat consumption.
- Helps you burn calories by increasing heat production.
- Favors the retention of muscle mass over fat.
In my experience, most women with PCOS don’t get enough protein. Achieving a 20% protein macro percentage requires a concerted effort. For someone on 2,000 calories per day, this means consuming 100 g of protein. That’s the equivalent of 16 oz (450 g) of lean meat per day (weighed raw). In vegetarian terms, this is the equivalent of 22 oz (620 g) of tofu.
One of the big challenges with vegetarian-derived protein is that it usually comes with a lot of carbohydrates. Beans for example are around 20% protein. That’s pretty good. But they’re also around 60% carbs. These kinds of carbs are fine. But if you try to meet your protein requirements with them, your carb balance will be too high. And that won’t help with weight loss. This is why I recommend that women with PCOS eat more meat, fish, and eggs.
Animal-derived proteins are also more bioavailable. This means your body can better absorb them.
7. Enjoy High Fiber Foods
This one seems super boring but stay with me.
Remember how I said that women with PCOS gain weight more easily than others? Well, studies show that PCOS women with insulin resistance consume less fiber . This is a big problem because fiber helps with insulin resistance . Other studies show that small reductions in dietary fiber intake increase abdominal fat .
So, while you’re probably sick of hearing about it. The best diet for PCOS weight loss includes plenty of high-fiber foods.
I include many of these foods in my PCOS Diet Cheat Sheet.
Some of the best high-fiber vegetables for PCOS are garlic, artichoke, carrots, broccoli, and sweet potato. Lentils, beans, and peas are also excellent (as everyone knows). Nuts and seeds though are the richest source of dietary fiber. Chia seeds for example contain around 34% fiber.
8. Stop Inflaming Your Gut
The six steps above are good for PCOS weight loss because they help overcome insulin resistance. But chronic inflammation is another primary driver of PCOS-related weight gain.
Improving insulin regulation reduces this problem. But there are other ways that foods add fuel to an already out-of-control fire.
Industrial seed oils are pro-inflammatory. These include all your regular vegetable oil products from soy, corn, cotton seed, canola, sunflowers, etc.
A similar phenomenon occurs with gluten-containing foods. Lab studies have found that gluten increases intestinal permeability, even in healthy people . I’ve written at length about PCOS and gluten and why it’s important to avoid this food. I also have an article describing the nuances of PCOS and dairy. Much like gluten, avoiding dairy is a powerful way to reduce inflammation.
Reducing inflammation and healing the gut is key to managing PCOS. That’s why all the recipes in my free 30-Day PCOS Diet Challenge and 3-Day Meal Plan are gluten-free, dairy-free, and low in sugar. The benefits speak for themselves.
9. Stay On Top of Your Micronutrients
The best diet for PCOS weight loss goes beyond getting the right macronutrient balance. Micronutrients are important too.
Using birth control for PCOS increases the risk of nutrient inadequacies [21-23]. Taking metformin for PCOS depletes B12 levels . Because these pharmaceuticals are widely used “off-label”, they present an added hazard for the PCOS community.
But the best way to stay on top of your micronutrients is to eat a lot of non-starchy vegetables. They contain minerals and vitamins in a bioavailable form. Many also contain phytonutrients with antioxidant and anti-inflammatory effects. That’s nothing but helpful for weight loss and insulin regulation [25, 26].
Foods to Eat
The best foods to eat to lose weight with PCOS are aligned with the 8 steps described above.
- Beef, chicken, and pork
- Fish and seafood
- Olive oil
- Animal protein (see above)
- Coconut products
- Chia seeds
- Flax seeds
- Other nuts and seeds
- Black/red/wild rice
- Beans, peas, and lentils
- Starchy vegetables
Fiber Rich Vegetables
- Carrots and beetroot
- Fennel bulb
- Sweet potato
Nutrient-Rich Non-Starchy Vegetables
- Swiss chard, kale, spinach, and other leafy greens
- Tomatoes, eggplant, and peppers
- Cauliflower and broccoli
- Cucumber and zucchini
- Fresh fruit
- Coconut or almond milk yogurt
- Dark chocolate
- Homemade PCOS dessert recipes
Download this free PCOS Diet Cheat Sheet for a longer list of foods to eat.
Foods To Avoid
The following examples are common foods for PCOS weight loss that are best avoided.
- Anything with a lot of sugar in it
- Anything containing a lot of sugary-carbs
- Any gluten-containing food
- Dairy products (except for butter and ghee)
- “Vegetable” oils
- Processed foods
Other Lifestyle Changes
Other lifestyle changes can further enhance weight loss results from dietary changes.
Intermittent fasting, for example, improves metabolic health and drives weight loss [27, 28]. The health benefits of limiting eating to within an eight-hour window have been demonstrated in women with PCOS .
Improving sleep is also key to PCOS weight loss. Poor quality sleep is associated with increased markers of systemic inflammation . Studies have shown that inadequate sleep is also a recipe for making poor food choices. This is because sleep quality influences eating habits and preferences for sugary foods [31, 32].
Exercise can also help. Studies have shown how physical activity improves insulin sensitivity and body composition in women with PCOS [33, 34]. Both aerobic exercise and resistance training have been shown to help women with PCOS [35, 36].
The Bottom Line
The best way to lose weight with PCOS is to change how you eat. Rather than restrict calories, follow a PCOS diet for sustainable weight management. Achieving steady blood glucose levels is key. This is why it’s important to get your macronutrient balance right. Improving gut health and reducing inflammation provide another way that diet can help with PCOS weight loss.
Ready To Take Action?
Since 2010, Kym Campbell has used evidence-based diet and lifestyle interventions to manage her PCOS. After getting her symptoms under control and falling pregnant naturally, Kym now advocates for dietary change as part of any PCOS treatment plan. Combining rigorous science and clinical advice with a pragmatic approach to habit change, Kym is on a mission to show other women how to take back control of their health and fertility. Read more about Kym and her team here.
1Deswal, R., et al., The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci, 2020. 13(4): p. 261-271.
2Mann, T., et al., Medicare’s search for effective obesity treatments: diets are not the answer. Am Psychol, 2007. 62(3): p. 220-33.
3Cutler, D.A., S.M. Pride, and A.P. Cheung, Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Sci Nutr, 2019. 7(4): p. 1426-1437.
4Barrea, L., et al., Source and amount of carbohydrate in the diet and inflammation in women with polycystic ovary syndrome. Nutr Res Rev, 2018. 31(2): p. 291-301.
5Wang, J., et al., Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sciences, 2019. 236.
6González, F., Inflammation in Polycystic Ovary Syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids, 2012. 77(4): p. 300-5.
7González, F., et al., Hyperandrogenism sensitizes mononuclear cells to promote glucose-induced inflammation in lean reproductive-age women. Am J Physiol Endocrinol Metab, 2012. 302(3): p. E297-306.
8Popovic, M., G. Sartorius, and M. Christ-Crain, Chronic low-grade inflammation in polycystic ovary syndrome: is there a (patho)-physiological role for interleukin-1? Seminars in Immunopathology, 2019. 41(4): p. 447-459.
9Rostamtabar, M., et al., Pathophysiological roles of chronic low-grade inflammation mediators in polycystic ovary syndrome. J Cell Physiol, 2021. 236(2): p. 824-838.
10Rudnicka, E., et al., Chronic Low Grade Inflammation in Pathogenesis of PCOS. Int J Mol Sci, 2021. 22(7).
11Manore, M.M., Exercise and the Institute of Medicine recommendations for nutrition. Curr Sports Med Rep, 2005. 4(4): p. 193-8.
12DiNicolantonio, J.J., et al., Fructose-induced inflammation and increased cortisol: A new mechanism for how sugar induces visceral adiposity. Progress in Cardiovascular Diseases, 2018. 61(1): p. 3-9.
13Jones, N., et al., Fructose reprogrammes glutamine-dependent oxidative metabolism to support LPS-induced inflammation. Nat Commun, 2021. 12(1): p. 1209.
15Hollon, J., et al., Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients, 2015. 7(3): p. 1565-76.
16Foroozanfard, F., et al., Effects of zinc supplementation on markers of insulin resistance and lipid profiles in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Exp Clin Endocrinol Diabetes, 2015. 123(4): p. 215-20.
17Asemi, Z., et al., Calcium plus vitamin D supplementation affects glucose metabolism and lipid concentrations in overweight and obese vitamin D deficient women with polycystic ovary syndrome. Clin Nutr, 2015. 34(4): p. 586-92.
18Samimi, M., et al., Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf), 2016. 84(6): p. 851-7.
19Jamilian, M., et al., Metabolic response to selenium supplementation in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Clin Endocrinol (Oxf), 2015. 82(6): p. 885-91.
20Fazelian, S., et al., Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis. J Trace Elem Med Biol, 2017. 42: p. 92-96.
21Palmery, M., et al., Oral contraceptives and changes in nutritional requirements. Eur Rev Med Pharmacol Sci, 2013. 17(13): p. 1804-13.
22Thorp, V.J., Effect of oral contraceptive agents on vitamin and mineral requirements. J Am Diet Assoc, 1980. 76(6): p. 581-4.
23Webb, J.L., Nutritional effects of oral contraceptive use: a review. J Reprod Med, 1980. 25(4): p. 150-6.
24Aroda, V.R., et al., Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab, 2016. 101(4): p. 1754-61.
25Gołąbek, K.D. and B. Regulska-Ilow, Dietary support in insulin resistance: An overview of current scientific reports. Adv Clin Exp Med, 2019. 28(11): p. 1577-1585.
26Cook, L.T., et al., Vegetable consumption is linked to decreased visceral and liver fat and improved insulin resistance in overweight Latino youth. J Acad Nutr Diet, 2014. 114(11): p. 1776-83.
27Kang, J., et al., Effect of Time-Restricted Feeding on Anthropometric, Metabolic, and Fitness Parameters: A Systematic Review. J Am Coll Nutr, 2021: p. 1-16.
28Adafer, R., et al., Food Timing, Circadian Rhythm and Chrononutrition: A Systematic Review of Time-Restricted Eating’s Effects on Human Health. Nutrients, 2020. 12(12).
29Li, C., et al., Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome. J Transl Med, 2021. 19(1): p. 148.
30Irwin, M.R., R. Olmstead, and J.E. Carroll, Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry, 2016. 80(1): p. 40-52.
31Blumfield, M.L., et al., Dietary disinhibition mediates the relationship between poor sleep quality and body weight. Appetite, 2018. 120: p. 602-608.
32Al Khatib, H.K., et al., Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study. Am J Clin Nutr, 2018. 107(1): p. 43-53.
33Almenning, I., et al., Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study. PLoS One, 2015. 10(9): p. e0138793.
34Cheema, B.S., L. Vizza, and S. Swaraj, Progressive resistance training in polycystic ovary syndrome: can pumping iron improve clinical outcomes? Sports Med, 2014. 44(9): p. 1197-207.
35Covington, J.D., et al., Higher circulating leukocytes in women with PCOS is reversed by aerobic exercise. Biochimie, 2016. 124: p. 27-33.
36Kogure, G.S., et al., Resistance Exercise Impacts Lean Muscle Mass in Women with Polycystic Ovary Syndrome. Med Sci Sports Exerc, 2016. 48(4): p. 589-98.