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Prescription weight loss that puts you first
Reviewed by Craig Primack, MD, FACP, FAAP, FOMA
Written by Vanessa Gibbs
Published 04/16/2024
Updated 10/31/2024
Polycystic ovary syndrome (PCOS), formerly known as polycystic ovarian syndrome, is a hormone disorder that commonly affects women.
PCOS can affect your health in a number of ways, like increasing your risk of infertility and insulin resistance. But one of the most common symptoms of PCOS is difficulty losing weight.
Weight loss can be more challenging with PCOS, but that doesn’t mean it’s impossible. Here’s everything you need to know about how to lose weight with PCOS.
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If you have PCOS and you're trying to lose weight, you might try:
Eating more whole foods
Weight loss medication
Upping your protein intake
Eating more fiber
Adding healthy fats to your diet
Moving your body more
Drinking more water
Getting more sleep
Finding healthy ways to manage stress
Keep scrolling for detailed tips and guidance.
What’s the best PCOS diet? Generally, you’ll want to prioritize whole foods and minimize ultra-processed foods. This can support healthy blood sugar regulation, hormonal balance, and weight management.
PCOS-friendly foods that support weight loss include:
Fruits and vegetables
Whole grains and complex carbs like brown rice, oatmeal, and whole-wheat bread
Lean proteins
Healthy fats
As for foods to avoid with PCOS, try to limit highly processed foods, which tend to be high in saturated fat, sodium, or added sugar. They’re also usually low in fiber, vitamins, and minerals.
Examples of ultra-processed foods include:
Cookies and other baked goods
Candy
Soda
Fruit juice
Energy and sports drinks
Packaged snacks and cereals made with refined white flour
White bread, white rice, and pasta made with refined white flour
Processed meats, like hot dogs
Eating these foods frequently can promote inflammation, hormonal imbalance, and weight gain.
If you have obesity, your healthcare provider may recommend a calorie deficit to help promote weight loss.
To hit a calorie deficit, you might eat around 500 to 750 fewer calories a day — but know that you don’t need to count calories if that’s not useful for you. You can just focus on nutritious food choices and healthy eating habits.
For personalized guidance on creating a PCOS diet plan, meet with a registered dietitian or a medical provider knowledgeable in PCOS management and healthy weight loss.
Weight loss medications can help you lose weight in a few different ways. Some of the most widely used and effective weight loss drugs include:
Metformin. Metformin is commonly prescribed for PCOS, but it can also help with weight loss — a win-win. This medication can reduce insulin resistance, improve glycemic control, and decrease appetite — helping you stick to healthy portions and food choices. If you’re already taking metformin for PCOS management, you may benefit from additional (or alternative) medications.
GLP-1 receptor agonists. These medications — think Ozempic®, Wegovy®, and compounded GLP-1s — work by reducing appetite, regulating blood sugar, curbing cravings, and even quieting food noise (mental chatter about food).
Topiramate. Topiramate (Topamax®) also suppresses your appetite, leading to reduced food intake and increased feelings of fullness. It can also alter reward pathways to decrease binge eating.
Contrave®. Contrave contains naltrexone and bupropion, a combination of two medications that may reduce food cravings and decrease appetite.
A healthcare provider can let you know if you’re a good candidate for weight loss injections or pills and which ones might work best for you.
You can connect with licensed providers online on the Hers platform. We offer access to weight loss medications like compounded semaglutide and custom oral weight loss kits — which can include a combination of meds like metformin, bupropion, topiramate, and naltrexone.
Protein can help you feel fuller, curb cravings, and preserve lean muscle mass as you lose weight.
Opt for lean protein sources like:
Chicken
Turkey
Fish
Tofu
Tempeh
Beans
A 2024 systematic review and meta-analysis looked at eight trials that included 300 women with polycystic ovarian syndrome. It found that a high-protein diet could help improve insulin resistance in women with PCOS. This might help with weight loss.
Just like protein, fiber can help you feel fuller for longer, making it easier to avoid overeating and stick to nutritious food choices.
High-fiber foods include:
Whole grains like brown rice, oats, barley, and quinoa
Legumes like beans, peas, and lentils
Veggies like sweet potatoes, artichokes, carrots, and broccoli
Fiber can also help prevent spikes in blood sugar levels.
You don’t need to be afraid of fats. Healthy fats are great for heart and brain health, hormone production, and — yes — weight loss.
Get your healthy fats from:
Avocados
Nuts and seeds
Olive oil
Hummus
Fish
Try adding a couple of healthy fats to your daily meals and snacks.
Along with weight loss, exercise can help improve insulin sensitivity and reduce the risk of health complications associated with PCOS, like heart disease and diabetes.
Experts recommend:
At least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week
Muscle-strengthening activities two or more days each week
To get your minutes and steps in, rotate a combination of activities you enjoy like:
Jogging
Swimming
Biking
Playing tennis
Joining a high-intensity group fitness class
Strength training exercises can increase lean muscle mass, boost metabolism, and support weight management. Try:
Using resistance bands
Doing bodyweight exercises
If you’re new to exercise, start slowly and listen to your body as you gradually increase the intensity or duration of your workouts. Doing physical activity with a friend or in a group can make it more enjoyable.
We’ve got a weight loss workout plan to follow to get you started.
Water can help you lose weight and manage polycystic ovarian syndrome.
Staying hydrated helps regulate hormone levels, supports metabolism, and aids in healthy weight maintenance. It can also help alleviate symptoms like fatigue and bloating and help your body flush out waste, digest fat, and reduce inflammation.
Furthermore, staying hydrated can help regulate your appetite and prevent overeating, especially when you drink water right before or during meals and snacks.
To stay hydrated:
Incorporate plenty of water-rich fruits and vegetables into your diet
Sip water throughout the day
Drink water before or during meals
If you get tired of plain water, try substituting it with seltzer, herbal teas, or water flavored with lemon or cucumber slices occasionally.
Getting enough sleep is essential for healthy hormone regulation, metabolism, weight management, and overall health.
Sleep deprivation, on the other hand, is associated with unintentional weight gain. It can also disrupt hormones, particularly those involved in appetite, stress response, and insulin sensitivity.
Not to mention that when you don’t sleep well, you can feel like garbage — which can exacerbate fatigue, mood swings, and cravings.
Experts recommend adults get seven to nine hours of quality sleep a night.
You’re more likely to experience sleep problems like sleep apnea and sleep disturbances if you have PCOS. So it’s even more important to prioritize good sleep hygiene habits like:
Following a regular sleep-wake schedule (going to bed and getting up around the same time each day)
Doing a relaxing bedtime routine
Creating a sleep-promoting bedroom using things like comfy PJs, breathable bedding, and white noise (if needed)
Avoiding screens close to bed, as the blue light can disrupt melatonin production and make it harder to fall asleep
If you think you have sleep apnea, consult your healthcare provider.
Stress can do a number on your sleep, appetite, and weight loss efforts. You might stress eat, choose not-so-nutritious foods, and slump on the couch rather than get outside for a walk.
Plus, high levels of the stress hormone cortisol can trigger your body to store more fat around your midsection, something you may already experience with PCOS.
To help, try adopting some stress-management techniques like:
Journaling
Meditating
Practicing yoga
Going for walks in nature
Spending time with loved ones
Reach out to a healthcare professional if you need extra support with your mental health.
Find answers to frequently asked questions about polycystic ovary syndrome and how to lose weight with PCOS below.
PCOS is characterized by an imbalance in hormones, including:
Androgens. These are often referred to as “male hormones,” although both men and women produce them. People with polycystic ovary syndrome typically have an excess of androgens like testosterone.
Insulin. Many women with PCOS have insulin resistance, meaning their cells don’t respond effectively to insulin. This leads to high insulin levels in the blood, which can stimulate the ovaries to produce more androgens and exacerbate hormonal imbalances.
Estrogens. While estrogen levels can vary in polycystic ovary syndrome, some women may have more estrogen than progesterone due to irregular ovulation.
Progesterone. Women with PCOS often have low levels of progesterone, as irregular ovulation leads to fewer menstrual cycles where progesterone is produced after ovulation.
The word “polycystic” in polycystic ovary syndrome refers to the development of multiple cysts on a woman’s ovaries. They’re a result of follicles in the ovaries that fail to release eggs regularly because of hormone imbalances.
While the exact cause of PCOS remains unclear, genetics, insulin resistance, and inflammation are thought to be key factors.
Symptoms of PCOS include:
Irregular menstrual cycles
Heavy or long periods
Excess hair growth (hirsutism)
Skin changes and acne
Higher body mass index (BMI), obesity, and difficulty losing weight
PCOS belly — weight around your middle
Infertility or trouble getting pregnant
PCOS can lead to a higher risk of developing obesity-related health conditions like type 2 diabetes, high blood pressure (hypertension), and cardiovascular disease.
It may be tricky, but weight loss with PCOS is absolutely possible with a comprehensive approach.
Adopting a lifestyle with regular movement and a nutrient-rich diet can be particularly beneficial.
Additionally, some women with PCOS may benefit from medications or supplements prescribed by their healthcare provider to help manage symptoms and support weight loss.
While losing weight with PCOS may require patience and persistence, it can significantly improve your symptoms and overall health.
PCOS can cause weight gain — and make weight loss harder — in several ways.
First, insulin resistance is common in PCOS. To understand what this means, let’s start by breaking down how insulin is supposed to work.
When you eat, your body digests carbohydrates into sugar (glucose) molecules that travel to your bloodstream. In response, your pancreas releases insulin, which helps glucose get into your cells to be used for energy.
With insulin resistance, cells don’t respond as well to insulin and sugar is left in your blood, resulting in prolonged high blood sugar levels. The pancreas keeps trying to produce more insulin, resulting in high levels of insulin in the blood.
Insulin resistance can promote fat storage, particularly around the abdomen, and make it harder for your body to use stored fat for energy. High insulin levels can also stimulate your ovaries to produce more androgens, further disrupting hormonal balance and promoting weight gain.
What’s more, the hormonal imbalances in PCOS (high androgen levels and lower levels of female hormones) can influence metabolism in a way that encourages more fat accumulation.
Finally, having irregular periods and hormone fluctuations with PCOS can trigger cravings for calorie-dense foods and make it harder to manage appetite. This makes sticking to nutritious food choices and healthy portions more difficult.
PCOS weight gain is frustrating, but with a multifaceted approach to healthy habits, you can regain control of your weight, health, and wellness.
If you’re looking to lose weight with PCOS, remember:
You’re not alone. Millions of women live with polycystic ovarian syndrome and the many challenges it can bring. If you’re finding PCOS weight loss hard, know you’re not alone, and it’s not your fault.
There are options. PCOS may present obstacles, but that doesn’t mean you’re defenseless against them. Healthy lifestyle habits, along with weight loss medications in some cases, can be very effective.
It’s about more than weight loss. The habits proven to support healthy weight management with PCOS are also beneficial for your overall wellness. A combination of good nutrition, regular movement, and regular sleep will serve your long-term quality of life.
If you’re considering a weight loss drug like Ozempic for PCOS weight loss, we can help. Take our free weight loss assessment to see which treatment options could work for you.
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