Women with PCOS have multiple abnormalities that require attention, including oligomenorrhea or anovulation, hyperandrogenism (hirsutism, acne, scalp hair loss), polycystic ovaries, and metabolic risk factors such as obesity, insulin resistance, dyslipidemia, and impaired glucose tolerance. Weight loss can restore ovulatory cycles and improve metabolic risk and is the first-line intervention for most women recommended by the Endocrine Society Clinical Guidelines.
While weight loss can be effective in helping women reach goals of regular menstruation, desired fertility, decrease unwanted hair growth and acne, and decrease metabolic risk factors, most women find the task of weight loss to be extremely challenging. Most women struggle with weight loss for three reasons, they believe they must lose large amounts of weight to be successful, they are using restrictive dieting methods that are not sustainable, and they rely on motivation instead of building habits. Even a modest weight loss of 5 to 10 percent reduction in body weight may result in restoring ovulatory cycles.
Lifestyle changes, including diet and exercise for weight reduction, are not one size fits all, but restricted calorie diets combined with exercise are most effective. While some women with PCOS are more successful with low carb diets, there is no good evidence that one type of diet is superior to another for women with PCOS.
You have the freedom to pick a way of eating that supports your weight loss goals, your overall health, and your lifestyle. Here are 5 tips to make weight loss easier.
Tip # 1: Eat in a Caloric Deficit
But don’t rush to a 1200 calorie diet. This is one of the most common mistakes I see women sometimes doing on their own and sometimes on the advice of a coach or healthcare provider. Yes, it will work, but it won’t be enjoyable or sustainable, and if you start off at a smaller deficit, you will likely be more successful because your body will be able to lose weight for a longer period of time. If you eat 500 calories per day less than what you have currently been eating, you could lose up to 1 lb per week. The human body isn’t a perfect calculator, so the amount of weight loss will vary, but 0.5-2lbs of weight loss per week is realistic. It is important to measure and track how much you are eating when in a weight loss phase. This allows you to actually learn how to eat the right amount of food, so you won’t have to track forever. It’s recommended to limit or remove sugary drinks and excess alcohol, but otherwise, allow yourself some flexibility in what you choose to eat. It’s important to choose high-quality foods like vegetables, fruits, proteins, and grains, but mixing in your favorite sweet or salty snack in small amounts will prevent binge eating behavior and giving up on the entire process.
Tip # 2: Eat Enough Protein
Protein helps build and repair muscle tissue and can lead to more weight loss. Protein helps you feel full at meals, satisfies hunger longer, and therefore causes you to eat less throughout the day. Higher protein diets help to maintain current muscle mass and increase the growth of new muscle mass. The more muscle mass you have, the higher your metabolic rate will be, meaning you will burn more calories naturally. Protein can also improve the body’s blood lipids and glucose levels. Calorie and protein requirements are highly individual, but a general rule of protein needs for fat loss is 0.8-1g of protein per pound of body weight. In general, choosing high-protein food at every major meal will help you see results over time. Protein can come in any form you like – plant or animal-based.
Tip # 3: Strength Train
Don’t be fearful of strength training/weight lifting. After nutrition and calorie balance, it is the best way to help you lose excess fat. Beginners should start slowly, but as you grow accustomed to the weights, you must push harder. Once you are safe with your weight lifting movements, challenge yourself to heavier weights or increase the reps. Consistency is key with any training – if you are jumping from workout to workout with no plan in mind, you likely won’t make progress you expect for putting in that time. What about cardio? I recommend moving in a way you enjoy but know that you do not need endless hours of running for weight loss. In fact, strength training is superior to cardio when it comes to fat loss. If you enjoy cardio, keep it up, but add in a few days of strength training to help you reach your weight loss goal.
Tip # 4: Monitor Sleep and Stress
Even if your diet and training are perfect, excessive stress and sleep deprivation can keep you from achieving those fat-loss goals. Increased cortisol promotes body fat and makes it harder to lose weight, especially around the stomach. Decreases in leptin and insulin sensitivity can increase your ghrelin hormone, the primary hunger hormone. This causes you to feel hungry even when you don’t need to eat, and the “I’m full” message from leptin isn’t being registered, so body fat is stored instead of used for energy. You must prioritize sleep and stress management by removing any stressors you can, applying relaxation techniques, and getting at least 6-8 hours of sleep per night.
Tip # 5: Maintain Weight Loss– You Can’t “Diet” Forever
So, you have 50+ pounds to lose. Does that mean you work on a fat loss until you reach that goal? Probably not. Losing up to 10% of your body weight over 12 weeks is the goal for safe and long-lasting weight loss. When you have successfully reached that fat loss goal, your body has adjusted to eating lower calorie amounts, and if you “go back to old ways of eating,” your weight will go back up, progress is lost, and you feel frustrated. Instead, increase calories back to maintenance needs (approximately 300-500 calories per day above your current intake) and let your body and metabolism heal. You should eat to maintain your weight for 6-12 weeks before another fat loss period begins. You cannot constantly be working on weight loss.
You must think about your health goals in phases and enjoy each phase through the journey. Working with a trained coach can help you understand the process of weight loss for health and have long term success.