How to Treat PCOS: An Overview of Issues Affecting Success

Lifestyle advice is more than just weight loss - it encompasses multiple health indicators and constitutes a holistic approach to health. As polycystic ovary syndrome (PCOS) is a complex condition with multiple health risks, it’s important to consider all aspects of well-being. Learn more about the different types of PCOS and why PCOS needs to be diagnosed & treated even if you are not concerned with fertility in our other blog posts.

Not only do women with PCOS struggle to overcome barriers, but all women face numerous barriers to healthy lifestyle change. The available research shows all premenopausal women with or without PCOS are at a higher risk of dropout from nutrition & lifestyle interventions when compared to women of older age (Ee et al). Not to get on another soapbox of feminism and the unequal division of labour at home but women of reproductive age having higher dropout rates could be due to family responsibilities, poor partner support, low mood, lack of childcare for self-care or exercise, fatigue, and lack of time.

Despite knowing what may be healthy, many women still struggle to adopt the changes needed due to the roles and demands women face every day. This blog will outline the barriers women with PCOS may face and offer some strategies to overcome them.

Diets for PCOS + Weight Loss

A healthy diet (paired with regular physical activity) is beneficial for women with PCOS by helping them achieve and/or maintain a healthy weight, regulate hormones, improve metabolic factors (such as insulin resistance) and lead to improved body image. Even a 5-10% weight loss has been shown to improve health outcomes and PCOS symptoms.

Sticking to a diet is tough for anyone, but especially for women with PCOS. PCOS puts women at a metabolic disadvantage, requiring careful planning of macronutrients and foods to maximize satiety and prevent overeating.

Impact of PCOS on Hunger, Cravings & Appetite

Women with PCOS face unique challenges with hunger and satiety, with some research showing alterations in hunger and satiety hormones, and reports of hunger sooner after eating compared to women without PCOS (Ee et al).

Meaning some women with PCOS have difficulty feeling satisfied and full after meals. However, the research studies that have initially shown these differences in women with PCOS have not been repeated since which means that this research may not be 100% applicable to women with PCOS.

Check out our blog on how to stop cravings sweets after supper!

PCOS Hormone Levels

The majority of women with PCOS have insulin resistance and subsequently, high levels of insulin (hyperinsulinemia) which may predispose women with PCOS to gain weight (Ee et al). High levels of androgens may also predispose women with PCOS to store fat in their abdomens which can exacerbate insulin resistance (Ee et al).

PCOS & Metabolism

There is conflicting research showing women with PCOS may have altered metabolisms including lower metabolisms and metabolic inflexibility, meaning that the metabolism has a reduced ability to switch between burning fat for energy in fasting conditions from carbohydrates (Ee et al). The metabolic inflexibility in women with PCOS may be related to insulin resistance and hyperandrogenism in women with PCOS (Ee et al).

No one diet has proved superior to another for the purpose of weight loss, so it’s important to choose a diet that is both nutritionally complete and sustainable.

A sustainable diet is any diet that you can follow and enjoy for the rest of your life.

PCOS & Disordered Eating

The estimated prevalence of disordered eating among women with PCOS varies between 1.33 to 3 times higher than those without PCOS (Pirotta et al). An unhealthy relationship with food can make it difficult for women with PCOS to stay consistent with nutrition and lifestyle changes. Plus when you factor in that many women with PCOS struggle with hunger and fullness cues, fatigue, cravings, and feel disconnected from their bodies - staying consistent with diets for PCOS or exercise.

While weight loss can improve PCOS symptoms, we also need to make sure that we are not worsening any potential negative relationship between food and mental health. Yes, weight loss can help improve the severity of PCOS symptoms but weight loss does not cure PCOS nor does it mean you are healthier! Read more about improving PCOS without weight loss here or how to boost confidence without weight loss here.

PCOS Nutrition: Antioxidants