Why is weight loss so difficult when you have PCOS ?

Poly Cystic Ovary Syndrome is the most common hormonal condition in women. It affects hormone control, weight, fertility, body hair, skin, self esteem and mental health. In my work as a binge eating specialist and hormone health specialist, I come across over 30 women a day who have PCOS and also binge eat. Unfortunately, most women are never informed of this on the diagnosis. Instead, they are simply told to lose weight when weight gain is actually one of the side effects of this condition and many women are left perplexed and cannot understand what is going in their body.


Here are some reasons why weight loss is so difficult for women with PCOS
1. Insulin is a fat-storing hormone

78% of women with PCOS will have some form of insulin resistant and high amounts of insulin in their system. This makes it next to impossible to lose weight. If we look at this from a biochemical perspective you can say that you are either fed or fasting.

  • In the “fed” state, our body is focussing storing any nutrients you consumed in your meal. Carbs are broken down to glucose, protein is broken down to amino acids, and fat is shuttled out to the body’s cells for storage. We are in this state for a few hours after having a meal.

  • Whilst if we are in a “fasted” state, the muscles burn stored glucose (glycogen) and fat is mobilized from storage and burned for energy.

Unfortunately for women with PCOS, our body thinks it is always in a “fed” state. Because our insulin and blood glucose levels are always high, we are not able to use our body’s energy reserves, and we end up storing whatever we eat as fat. This is why many women with PCOS feel like even by looking at food we put on weight

Furthermore, because the vast majority (78%) of women with PCOS also have some degree of insulin resistance, all the sugar in our blood cannot get into the cells. So, although there is food available in our bloodstream, our cells are literally starving. This is what leads to intense carbo cravings especially sugar. No matter how strong your willpower is, eventually, you’ll end up giving in…feeding your cells is a basic biological need. This also explains why many women with PCOS tend to develop binge eating disorder or even binge and overeat regularly.

2. High levels of Androgens Cause Weight Gain

Most women with PCOS including myself will also have higher levels of “male” hormones. These hormones generally encourage fat storage in the abdomen. This explains why women with PCOS tend to gain it in the tummy region. In the belly, we have 2 types of fat: Visceral and subcutaneous. High levels of visceral fat can increase levels of insulin and androgens, which increases fat storage—creating a vicious cycle.

This is why most conventional doctors recommend that women with PCOS lose weight. However, they fail to consider that without adequate support to improve their hormone profile weight loss can be very difficult and can lead to the development of eating disorders.

3. Women with PCOS are 4 times more likely to have a slow thyroid

Unfortunately, a very common occurrence that goes hand in hand with PCOS is having a slow thyroid. Furthermore, For women who suffer from stress as the root have an overworked adrenal gland which signals to the thyroid to slow everything down so the body can focus on the “flight or fright” response. I don’t know about you, but most women I’ve met fall into the overstressed category whether they have PCOS or not!

A slow thyroid slows the metabolism, worsens insulin resistance and increases circulating testosterone by lowering SHBG (sex hormone-binding globulin), leading to more weight gain.

4. Dieting can lead to binge eating and eventual weight gain

We all know that 95% of diets don’t work. Studies have shown that people who diet are more than 3 times more likely to become obese than people who never dieted. So when. women are told to go on diets they are actually slowing their metabolism even more.

Following a restrictive diet is not sustainable for anyone and in fact women with PCOS are six times more likely to engage in disordered eating behaviours, especially binge eating and bulimia. Furthermore, women with PCOS tend to suffer from anxiety, and low self-esteem and poor body image and feelings of guilt and shame around food and this lead to even more comfort eating.

Many of my clients have told me that their doctors don’t believe how little they’re truly eating. But when I assess their nutrition status, I find that most are subsisting on 2 meals a day, or less than 1200 calories per day, which is much too low for an adult woman of reproductive age. Does this seem familiar to you?

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