This post was updated on July 25th, 2022

By Kym Campbell, BSc. | Updated July 25th, 2022

Medically Reviewed by Dr. Sarah Lee, M.D & Dr. Jessica A McCoy, Ph.D

Polycystic Ovary Syndrome (PCOS) affects around 1 in 10 women of childbearing age. More than half of these women are classified as overweight [1]. While a PCOS diagnosis can feel like a constant struggle, even modest weight loss of 5-10% can make a big difference [2-5] . Achieving a healthy weight helps with irregular periods, ovarian function, and unwanted hair growth. Other cardiovascular health markers are also improved. This includes things like insulin levels, visceral fat, high blood pressure, and more.

In this article, I explain the root causes of PCOS weight gain. I then share 15 important steps that can help you take back control of your health. To put these good ideas into practice, sign up for my next free 30-Day PCOS Diet Challenge.

The Cause Of PCOS Weight Gain

Losing weight with PCOS is easier said than done. Women with PCOS gain weight easier than people without PCOS [6] . We also face extra obstacles to weight loss [7].

PCOS weight gain is caused by hormonal imbalances. But these imbalances stem from insulin resistance and chronic inflammation. Insulin resistance causes higher rates of body fat accumulation and plays a key role in weight management [8-10]. Chronic inflammation also drives weight gain [11]. This has a significant genetic component, but environmental influences like diet and lifestyle can turn this dial up and down.

Addressing these mechanisms provides the pathway for almost every PCOS weight loss intervention. It’s the underlying reason why the following 15 steps work. Improving insulin regulation and reducing inflammation are key to losing weight with PCOS.

1. Reduce Your Sugar Intake

Reducing sugar intake is the single most effective dietary intervention for PCOS.

Most natural sources of sugar contain approximately 50% fructose and 50% glucose. Both of these compounds can make you gain weight.

Fructose is problematic because it’s metabolized by the liver like a toxicant. Because of its comparable long-term effects on metabolic health, some experts call fructose “alcohol without the buzz” [12] . It used to be thought that people gained weight because they overate a lot of high-fat foods. But current evidence now shows that fructose may be the biggest risk factor for obesity [13, 14] .

This is especially true for PCOS women. Research shows that overweight women with PCOS have high fructose levels [15]. Other studies indicate that high sugar intake is associated with greater abdominal fat [16]. These findings draw a straight line between reducing sugar intake and losing weight.

The glucose half of the sugar molecule can also be a problem for healthy weight management. While essential for life, an overabundance of dietary glucose can increase body fat. This is because insulin resistance can develop when exposed to chronic energy surplus [17].

Candy and soda are obvious targets for elimination, but many food items contain “hidden” sugars too. This PCOS foods to avoid list includes a list of common sugar-rich foods. These are some of the food items that women with PCOS should be particularly cautious of. Getting in the habit of checking nutrition labels is an important habit if you want to lose weight.

2. Eat Slow Carb & Low Carb, From Whole Food Sources

Besides reducing sugar consumption, lowering glycemic load is a powerful way to lose weight with PCOS. Glycemic load describes the total effect of a meal on your blood sugar levels. It’s a combination of the glycemic index (GI), which describes how quickly a food raises blood sugar levels, and how much you consume. It’s a proxy for how much insulin you’ll need to digest a meal. By reducing glycemic load, the body requires less insulin. This, in turn, reduces body fat accumulation [18, 19].

The simplest way to lower the glycemic load of your meal is to:

  1. Choose foods that are relatively low GI i.e. “slow carbs”.
  2. Eat a small amount of carbohydrate-rich foods i.e. “low carb”.
  3. Get your carbs from whole food sources. Processed foods can game the system by making low GI foods that are full of fructose (fructose is low GI).

Black rice, sweet potato, and quinoa are examples of relatively low GI, carbohydrate-rich whole foods. A “good” serving size for these foods is around half a cup (cooked). This is “low-carb” by most standards, but is enough to avoid ketosis. Discover the pros and cons of a keto diet for PCOS here.

For a comprehensive list of low GI whole foods, download this PCOS Diet Cheat Sheet.

3. Consume Healthy Fats

Despite dietary fat being incorrectly blamed for increases in obesity [20] , eating more fat can help with weight loss.

For a start, fat consumption has a positive effect on satiety and appears to regulate appetite [21]. Some of the fats, found in beef and lamb, can improve glucose tolerance, increase insulin sensitivity [22, 23], and reduce body fat [24, 25].

Coconut food products are also particularly useful for weight loss. These foods tend to be rich in medium-chain triglycerides which promote fat loss from the stomach and thigh areas [26, 27].

Oily fish, nuts, seeds, olive oil, and avocado are rightly promoted as “healthy” fats. But, saturated fats from whole foods sources are also good for PCOS.

Evidence from randomized controlled trials suggests that the consumption of saturated fats doesn’t increase heart disease risks [28]. As a result, many experts now oppose the US Dietary Guidelines for Americans recommendation to limit saturated fats. Nearly 20 papers published within the past 10 years, review the totality of data on saturated fat and cardiovascular outcomes. These papers show that the recommendation to limit saturated fats in favor of polyunsaturated alternatives lacks scientific rigor [29].

A list of recommended fats and oils can be found here in my PCOS Diet Cheat Sheet.

4. Get Enough Protein

Dietary protein impacts weight loss in several ways. It influences satiety, heat production, energy efficiency, and body composition.

In an article published in the American Journal of Clinical Nutrition, Dr. Paddon-Jones and colleagues [30] explain that:

  • Protein increases satiety to a greater extent than carbohydrate or fat consumption.
  • Higher protein diets are associated with increased heat production. This helps you burn calories faster.
  • Higher protein diets favor the retention of muscle mass over fat.

Animal-derived protein from meat, eggs, and seafood is preferred. These are “complete” protein sources containing all essential amino acids in a bioavailable form. Unlike most plant-derived protein sources, animal protein is also much lower in carbohydrates and higher in fat.

A list of recommended protein-rich foods can be found in my PCOS Diet Cheat Sheet here.

5. Eat High Fiber Foods

While the optimal diet for women with PCOS is often disputed, almost all experts agree that eating more dietary fiber helps with weight loss [31].

Studies show that obesity in women with PCOS cannot be explained by overeating or inactivity. But, women with PCOS tend to consume less fiber [32]. Even small reductions in dietary fiber intake may increase abdominal fat in high-risk individuals [33]. Because fiber consumption impacts insulin resistance [34], increasing intake of fiber-rich foods should be a key component of any PCOS weight loss diet.

Some of the best high-fiber foods for women with PCOS include garlic, artichoke, avocado, crucifers, and starchy vegetables. Passionfruit, pomegranate, blackberries, and raspberries are also rich in dietary fiber.

6. Eat Non-Starchy Vegetables

Non-starchy vegetables are a key recommendation for PCOS weight loss. This is especially true for vegetables that are dark green and deep orange/yellow. These foods provide essential micronutrients for sustaining good health. They also improve insulin regulation, which helps with weight loss [35, 36].

7. Avoid Inflammatory Foods

Insulin resistance causes the accumulation of body fat. But for women with PCOS, chronic inflammation is another cause of weight gain [37]. Inflammation is one of the root causes of all PCOS symptoms and can be caused by a wide range of environmental factors.

Diet is a key environmental input. Reducing foods that drive inflammation can not only help with weight loss but may also improve the entire spectrum of PCOS symptoms.

Common ways that diet can induce inflammation include:

  1. The over-consumption of readily available carbohydrates, especially sugar.
  2. Consumption of pro-inflammatory foods, especially vegetable oils, and processed foods.
  3. Foods that induce an allergic response.
  4. Foods where a subclinical intolerance may be present.

Of this last category, gluten and dairy tend to be the most common among women with PCOS. These ingredients are often primary drivers of weight gain. Elimination of gluten and dairy has played a key role in the success of thousands of women that have completed my Beat PCOS 10 Week Program.

8. Follow Your Hunger & Fullness Cues

Ironically, traditional dieting methods can be counterproductive to women with PCOS. Restriction diets that control calorie intake, often fail over the long run. Studies have shown that in the majority of cases, dieting causes weight gain rather than weight loss [38].

Add to this, the fact that PCOS is associated with high rates of disordered eating [39, 40], and you have a perfect recipe for disappointment.

Intuitive eating is a more realistic approach for long-term weight maintenance [41-43]. It’s particularly helpful for people that have struggled with binge eating in the past.

Intuitive eating recognizes that people can naturally regulate their caloric intake. Charts, calculations, and apps simply aren’t needed. This innate ability comes from hunger and fullness signaling hormones, like ghrelin and leptin [44]. These hormones respond well to a diet that’s high in protein and vegetables [45-49]. This is another reason why a whole-food-based PCOS diet is best for weight loss. You feel less hungry and more satisfied.

The Intuitive Eating Module included in my Beat PCOS 10 Week Program is especially popular for women that want to lose weight. As many participants discover, losing weight is as much about fostering a healthy relationship with food as it is about nutrition. To break free from yo-yo dieting, it’s essential to overcome the negative psychological impact of previous diets. We need to follow our natural hunger and fullness cues instead.

9. Consider Intermittent Fasting

Intermittent fasting, more correctly known as time-restricted eating, is a proven tool for improving metabolic health and weight loss [50, 51]. Studies have shown that for women with PCOS, limiting eating to within eight hours per day may improve body composition, insulin sensitivity, menstruation, chronic inflammation, and androgen regulation [52].

Excluding any potential risks for disordered eating, intermittent fasting is a useful way to further improve a PCOS diet.

10. Check Blood Glucose Levels

A low-carb diet drives weight loss by reducing blood glucose levels. This reduces the recruitment of insulin, which tends to store excess glucose as fat.

Blood glucose levels depend on many circumstances that change from day to day. The most important is the type and quantity of dietary carbohydrates. Total meal composition, sleep, stress, and exercise, also alter the glycemic response of any given meal.

By measuring and monitoring blood glucose levels, it’s possible to further optimize your diet for weight loss. What you want to see is a slow rise in blood sugars after you eat. A peak of less than 110 mg/dL (6.1 mmol/L) is good. This can be measured using a flash glucose monitor which samples a finger prick of blood. This type of monitor gives you a single snapshot in time. Continuous blood glucose monitors, by comparison, provide a more complete picture. These are the best devices for understanding how diet and lifestyle decisions impact weight loss.

Freestyle Libre by Abbott and Dexcom are the leading suppliers of continuous glucose monitoring systems.

11. Supplement Your Diet

Many dietary supplements can potentially help women with PCOS lose weight. While weight loss benefits tend to be small, Myo-inositol is one of the most popular. This naturally occurring nutrient is safe and effective at improving insulin sensitivity. This, in turn, produces modest weight loss [53-55]. Studies have shown that Myo-inositol is just as effective as the commonly prescribed insulin-sensitizing drug, metformin. Read my article on inositol and PCOS for more about this supplement.

There are many other nutritional supplements for weight loss that may be worth discussing with your doctor. Top of the list for women with PCOS are berberine [56], zinc [57] , calcium + Vitamin D [58] , carnitine [59] , selenium [60] , and chromium [61].

12. Exercise Frequently

Research shows how physical activity improves insulin sensitivity and body composition in women with PCOS [62, 63] . The best types of exercise for PCOS generally fall into one of two main categories, aerobic exercise, and resistance training. Aerobic exercise is understood to reduce inflammation [64] . Resistance training, by comparison, improves hormone regulation [65].

13. Reduce Your Stress Levels

Stress indirectly affects body weight through a variety of mechanisms [66]. It influences our eating behaviors and self-control. It makes us hungrier and causes carb cravings. Stress also makes us less active and reduces how much we sleep (see below).

Stress is a risk factor for even the healthiest individuals, but women with PCOS experience more stress than other people without PCOS [67]. This presents both a problem and an opportunity. On the one hand, women with PCOS need to be more mindful of managing their stress levels. On the other, any intervention that reduces stress is likely to aid in weight loss.

Some of the best direct stress-management tools include things like mindfulness meditation, guided relaxation exercises, and cognitive behavioral therapy. Physical activity is also a powerful way to reduce anxiety and depressive symptoms [68].

14. Improve Your Sleep

In case feeling great isn’t enough to motivate better sleep habits, improving sleep can also help with weight loss:

  • Sleep reduces stress [69] (see above).
  • Poor quality sleep is associated with systemic inflammation [70] , a primary cause of PCOS weight gain.
  • Sleep apnea adversely impacts insulin resistance and glucose tolerance in women with PCOS [71, 72].
  • Inadequate sleep quality influences eating habits [73].
  • Getting more sleep reduces preferences for sugary foods [74].

Overcoming insomnia can be a significant challenge for many people. But there are many ways to improve sleep quality. Things like prioritizing an early bedtime, and reducing blue light exposure in the evenings. Relaxation exercises and sleep meditations can also make a positive impact on weight loss.

15. Get Your Thyroid Checked (Properly)

Thyroid dysfunction affects women with PCOS at roughly three times the rate found in non-PCOS populations. A large percentage of these cases are undiagnosed [75]. When left untreated, subclinical hypothyroidism presents a significant barrier to weight loss.

Thyroid dysfunction can be particularly difficult to diagnose in many women with PCOS. For example, the elevated androgen levels seen in PCOS can decrease the thyroid hormone, thyroxine-binding globulin (TBG) [76]. This means that for many women with PCOS, TSH, and T4, the biomarkers that are usually used to screen for thyroid issues, will be normal. A proper diagnosis is only possible with a full thyroid panel that includes TBG, T3, and reverse T3 biomarkers.

Getting a full thyroid panel is recommended for anyone wanting to lose weight with PCOS. This is especially important if the benefits of diet and lifestyle interventions appear to be limited.

The Bottom Line

For many women, having PCOS means it’s easy to gain weight and hard to lose it. But despite the added barriers to weight loss, it’s certainly possible with the right information and support.

Hundreds of thousands of PCOS women have started losing weight using the free resources available on this website. If you’re ready to take back control of your health then join me for my next free 30-Day PCOS Diet Challenge.

During this live event, you’ll put into practice many of the weight loss ideas described in this blog. The Challenge includes free weekly meal plans and helpful video lessons. It’s hosted within a vibrant community of like-minded women and has been the start point for many PCOS weight loss success stories.

Ready To Take The Next Step?

  • Download my free 3-Day PCOS Diet Meal Plan here. This is perfect for getting started before the next 30-Day Challenge begins.
  • Join my PCOS Monthly Meal Planning Service here. This service includes hundreds of PCOS recipes within a pre-populated, yet customizable meal plan. It’s designed to save you time and help you apply a PCOS diet.
  • Sign up for my next Beat PCOS 10-Week Program. This is a comprehensive live program that runs quarterly. Topics covered include diet, PCOS-centric emotional eating, exercise, stress management, and more. The 10-Week Program includes the same recipes and meal plan as my monthly meal planning service.
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