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  • Caroline Spurr

PCOS and Belly Fat: What’s the Connection?

Found out you have PCOS and were told to lose weight? But that stubborn PCOS belly! What is it exactly and how do we combat it for good? If you’re looking for tips to overcome PCOS belly, keep reading!

What is PCOS?

Polycystic ovary syndrome is a health condition that can result in unbalanced hormones and infertility in women. To be diagnosed with PCOS, women need to have at least two of the following:

  • High testosterone levels

  • Irregular or absent periods

  • Cysts on their ovaries

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Women with PCOS face a series of other challenges, like higher cravings, facial hair growth, and risk of developing other health conditions including diabetes.

Read my blog on the different types of PCOS to learn more.

What Causes PCOS Belly Fat?

Insulin Resistance

Insulin is secreted by your pancreas to shuttle glucose (sugar) to the appropriate spots in your body. Insulin resistance occurs when insulin isn’t being used as efficiently by the body anymore, requiring more insulin to move the sugars along.

what does a pcos belly look like

Insulin works like a key for the cells in our bodies, it unlocks the cell door to bring nutrients like glucose into our cells. Insulin is released from your pancreas after an increase in blood sugar in order to clear glucose from your blood.

If you have insulin resistance, the locks on your cell are harder to unlock.

Your body could pump out all of the insulin it wants but if the lock on your cell is busted, your body will have a harder time clearing sugar from your blood which can increase the risk of developing diabetes, heart disease, and weight gain.

Check out another blog on common conditions that are associated with PCOS.

Women with PCOS are more likely than healthy women to have insulin resistance. This remains true for all women with PCOS - whether in a smaller or larger body.

One study noted that for women with PCOS, around 60% with a normal BMI were insulin resistant, compared to almost 80% of overweight women and nearly 100% of obese women.

This is likely due to the higher amount of visceral (organ) fat that women with PCOS have.

Visceral fat releases various hormones related to health, so an accumulation of this type of fat can cause a hormonal imbalance, leading to health conditions such as metabolic syndrome, cardiovascular disease and even several types of cancer (prostate, breast and colorectal).

There appears to be a connection between visceral fat in women with PCOS and elevated blood sugars (both fasted and after eating). Even in women without PCOS, it seems that with increasing visceral fat comes increasing blood sugars. Remember - the body needs insulin to unlock the cells to move the sugar. High blood sugars could indicate insulin resistance.

Insulin resistance tends to result in a particular distribution of fat, known as an “apple” shape. Fat is centralized around the belly, in contrast to a “pear” shape, where fat is distributed below the waist, in the thighs and glutes. Hence, PCOS “belly”.

With insulin resistance, too much sugar in the blood is overwhelming for the body as it can’t act fast enough to respond. In such a scenario, it sends some of the excess sugar to be stored in the fat cells, further perpetuating a PCOS belly.

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On another note, because of the role of vitamin D in fat tissue, inadequate vitamin D could contribute to insulin resistance. People living in northern climates and people with more body fat are more likely to be deficient in vitamin D, so supplementation is key.

Read my blog for more information about vitamin D!

PCOS High Testosterone

Many women with PCOS have high testosterone, which may or may not be accompanied by physical signs (facial hair, oily skin/acne) or clinical signs (high testosterone in blood). Women with phenotypes A, B and C all have high testosterone, comprising the majority of women with PCOS.

pcos high testosterone

Read my blog about the different types of PCOS!

High testosterone can result from an imbalance of steroid hormones. The “steroid hormones” are hormones made from the ovaries, testes or adrenal cortex.

In particular, women with PCOS may have elevated dehydroepiandrosterone sulfate (DHEAS).