PCOS and Weight Gain: Causes, Symptoms, and Solutions

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects people assigned female at birth, particularly during their reproductive years, and one of the most challenging aspects of PCOS is its association with weight gain. This connection between PCOS and weight gain involves hormonal imbalances, metabolic issues, and lifestyle factors. In this discussion, we’ll explore the connection between PCOS and weight gain, examine its impact on overall health, and explore potential strategies for managing both PCOS and weight gain.

The ABCs of PCOS

PCOS presents a confusing constellation of findings, including irregular periods, elevated levels of androgens (male hormones), and multiple small cysts on the ovaries. Acne, thinning scalp hair, and excess hair growth on the face and body are also prevalent features. We don’t fully understand what causes PCOS, but we do know it involves a complex interplay of genetic and environmental factors. We also know that PCOS is the most common cause of infertility and that insulin resistance is common. That is, people with PCOS can make insulin (in the beta cells of the pancreas), but their bodies can’t use it effectively. Normally, insulin helps glucose enter cells, where it can be used for energy. But if cells are resistant to insulin, excessive amounts of blood sugar build up in the bloodstream, which can cause type 2 diabetes. Excess insulin also causes your body to make and store more fat. If this sounds like double whammy, it is.

The Connection Between PCOS and Weight Gain

There are three primary ways PCOS contributes to weight gain:

• Insulin Resistance: When the body becomes resistant to insulin, the pancreas compensates by making and releasing more of it to maintain normal blood sugar levels. It’s like this: You eat. Your blood sugar rises. Your pancreas releases insulin to drive glucose into cells and out of your bloodstream in order to bring your blood sugar back down. Your ‘insulin-resistant’ cells don’t let enough sugar exit your bloodstream. Your pancreas releases more insulin to counteract high glucose levels. Over time, elevated insulin levels contribute to fat storage, especially in the abdominal area.
• Hormonal Imbalances: PCOS causes an imbalance in hormones, especially androgens (testosterone), and these hormone imbalances increase appetite (especially for high-calorie foods) and promote abdominal fat deposition.
• Metabolic Factors: People with PCOS often suffer from metabolic syndrome, a cluster of conditions that increases the risk of heart disease, stroke, and type 2 diabetes. High blood pressure, abnormal lipid profiles, and central obesity (excess fat around the abdomen) are commonly seen with metabolic syndrome.

How PCOS and Weight Gain Impact Health

Elevated androgen levels. Ovarian cysts. Acne. Insulin resistance. Abdominal fat. Metabolic syndrome.

As you might imagine, PCOS and its related causes and sequelae (conditions that are a consequence of a disease) can wreak serious havoc on health and wellbeing. And, oftentimes, without a person even knowing it. Add weight gain to the mix and PCOS quickly becomes a profoundly serious health condition. These are just a few of the conditions people with PCOS can develop, especially if they are overweight:

• Diabetes: More than half of people with PCOS develop type 2 diabetes by age 40.
• Gestational Diabetes: Getting pregnant with PCOS is possible, but mom’s risk of developing diabetes during pregnancy goes up substantially. Additionally, gestational diabetes, independent of other factors, puts mom and baby at risk of developing type 2 diabetes later in life.
• Heart Disease: Insulin resistance, increased fat deposition, high LDL (‘bad’ cholesterol), and low HDL (‘good’ cholesterol) puts people with PCOS at higher risk for cardiovascular disease and events.
• High Blood Pressure: This ‘silent killer’ can damage the heart, brain, and kidneys.
• Stroke: Plaques (cholesterol and white blood cells) can clog blood vessels and cause a stroke.
• Sleep Apnea: This disorder, which causes breathing to stop temporarily on-and-off throughout the night, raises the risk for heart disease and type 2 diabetes and causes excessive daytime sleepiness, which can lead to accidents at work and on the road.
• Anxiety and Depression: PCOS is linked to anxiety, depression, and other mental illnesses.

Managing PCOS and Weight Gain

Current data suggests that weight loss is the single best modification a person with PCOS can make in order to improve the metabolic issues, endocrine function, reproductive health, cardiovascular fitness, and psychological features associated with this illness. In fact, even a small amount of weight loss of 5% can improve insulin resistance, hormone levels, menstrual cycles, fertility, and quality of sleep and life. There are numerous lifestyle and medical interventions that can be used to manage weight gain and improve PCOS.

Improve Your Diet

• Eating a low glycemic, low carb diet reduces insulin levels and helps weight loss.
• Including more fiber in your diet can make you feel fuller after a meal and stave off hunger.
• Getting enough lean protein helps stabilize blood sugar, which promotes a healthier weight.
• Healthy fats can boost metabolism and curb appetite.
• Limit processed foods. These food items often contain obscene amounts of salt and sugar, which can contribute to high blood pressure and insulin resistance.
• Consider an anti-inflammatory diet. A Mediterranean diet, replete with fresh fruits and vegetables, whole grains, olive oil, and omega-3 foods like fish, can reduce inflammation and help lose weight.

Exercise Regularly

Both aerobic and weight training exercises help people with PCOS decrease body fat, increase metabolism, and improve insulin sensitivity. Even milder exercise routines, like walking for 30 minutes every day, can make a big difference.

Get More Sleep

Lack of restful sleep is linked to obesity. Your doctor might suggest a sleep study to rule out sleep apnea.

Reduce Stress

High cortisol levels, due to chronic stress, is linked to insulin resistance and abdominal fat. Managing stress through mindfulness, meditation, yoga, and other stress-reducing activities (time outdoors) may help lower cortisol levels.

Insulin-sensitizing Medications

Medications like metformin improves insulin sensitivity and aids in weight management. Newer drugs developed for type 2 diabetes might also be effective.

Hormone Therapy

Oral contraceptives and other hormone-based therapies can regulate menstrual cycles, manage androgen levels, and assist in weight management.

Psychological Support

Counseling and support groups can be crucial in helping individuals cope with the emotional challenges that accompany PCOS and its related conditions.

Bariatric Surgery

Some people with PCOS might be candidates for weight-loss surgery.