If a woman has problems with her hormones, polycystic ovary syndrome (PCOS) may be the diagnosis. In PCOS, the ovaries produce abnormal amounts of androgens, sex hormones that are more common in men and usually only found in small amounts in women. Also, very small cysts, or fluid-filled sacs, can develop on a woman’s ovaries (although some women with PCOS do not have cysts). As a result, women’s periods may be irregular. For example, this could mean very few periods or periods that abnormally last several days in a row.
Symptoms of PCOS
Not only does PCOS often cause discomfort and frustration with menstrual periods, it can also cause problems with a woman’s ability to conceive. According to the Centers for Disease Control and Prevention, between six and 12 percent of women of reproductive age have PCOS, and it is one of the most common causes of female infertility. Higher levels of androgens can lead to several other symptoms in women with PCOS, such as:
- mood swings
- increased body hair in unwanted or more masculine areas
- weight gain in more masculine areas (ie around the stomach)
- acne/oily skin
- thinning hair in male areas (ie the top of the head)
- sleep apnea
PCOS and insulin resistance
Although the cause of PCOS is not clear, it is clear to doctors that most women with PCOS experience some level of insulin resistance, a condition that is linked to problems with weight gain and weight loss because it causes the body to respond differently. respond to calories. It can be recognized physically by symptoms such as dark spots on the skin or skin tags. It can also create an endless cycle of despair. while losing weight can help alleviate PCOS symptoms, women with PCOS may also have a harder time losing weight. This can create a seemingly never-ending cycle of frustration and despair for these women, who may already be struggling with other challenging symptoms associated with this diagnosis.
How and why does insulin resistance affect weight? We know that insulin makes it easier for the body to convert glucose into energy, but insulin resistance interferes with this process. When the body’s cells resist insulin signals, the pancreas produces more insulin, which leads to negative disruption of appetite-regulating hormones, increased hunger, more fat storage, and increased blood sugar, which causes the extra sugar to be stored as fat. Sleep apnea is also associated with insulin resistance and weight gain.
Many True You patients struggle with PCOS
True You Weight Loss sees many female patients who already have a PCOS diagnosis, as well as some who are not yet diagnosed. These patients tend to be frustrated by their inability to lose weight with conventional methods, combined with struggling with other symptoms of the disease, such as infertility.
True You nurses and health coaches diligently manage PCOS by having in-depth conversations with patients about their symptoms and menstrual cycles. While it’s rare for our team to “officially” diagnose PCOS, we often spot the signs and refer patients back to their OB/GYN, primary care provider, or endocrinologist for further testing (which may include blood tests, ultrasounds, and etc):
“At True You, we have helped many PCOS patients achieve their weight loss goals. As a result, we’ve seen many patients overcome infertility and become pregnant if that’s their last hope,” says Emily Weaver, BSN, RN, AGPCNP, True You Nurse Practitioner. “PCOS patients should know that they can have a perfectly healthy pregnancy after weight loss surgery. In fact, achieving a healthy body weight has a positive effect on conceiving.”
Weight loss strategies for PCOS patients
Although there is no cure for PCOS, it can be effectively and successfully managed with a good weight loss plan, lifestyle changes, and professional support. According to Kathleen Walton, MS, RD, LDN, a registered dietitian at True You, optimizing your diet is an important strategy that PCOS patients can use to help with weight loss.
“Spreading macronutrients, eating low-glycemic index foods, and limiting processed foods are nutritional strategies to combat PCOS,” Kathleen said. “We encourage patients to fill half of your plate with low-glycemic foods to balance blood sugar and avoid spikes and crashes that can lead to weight gain. Stress management is also key to PCOS weight loss success.”
Here are some other weight loss strategies Kathleen recommends for PCOS patients:
- follow an individual plan for the distribution of macronutrients of quality proteins and fats
- eat carbohydrates with a low glycemic index
- pair carbs with protein and healthy fats (to lower the glycemic index)
- limit processed foods that are high in saturated fat, sugar, and sodium; these hyper-palatable foods will make you crave more saturated fat, sugar, and sodium
- limit red meat and choose other proteins, such as oily fish, instead
- eat a high fiber diet
- reduce inflammation by eating whole (natural, unprocessed) foods
- avoid “malnutrition” because calorie restriction can affect metabolism and lead to weight gain
- manage stress levels by creating a work/life balance
- engage in lower-stress exercises and activities such as yoga, weight lifting, breathing techniques, and meditation
The best foods for a healthy PCOS diet include quality proteins such as chicken breast, turkey, eggs, yogurt, cottage cheese; fatty fish, for example, salmon; nuts such as walnuts and almonds; leafy greens such as kale and spinach; dried beans and lentils; dark red fruits such as red grapes and blueberries; healthy fats such as olive oil and avocado; and vegetables such as broccoli and cauliflower. Meanwhile, foods to avoid that can trigger PCOS flare-ups include refined carbohydrates such as pastries and white bread; fried food and fast food meals; sweet drinks; processed meats such as hot dogs and deli meats; dairy; solid fats such as margarine; and excess red meat such as steak and hamburger.
“Like limiting certain foods, limiting certain types of exercise is also important for PCOS patients,” adds Emily. “High-intensity cardio, for example, can put the body under high stress, which causes it to release more cortisol and androgens. For a woman with PCOS, this will exacerbate symptoms. Therefore, it is important to engage in low-impact exercise such as yoga and weight training so that the body can use insulin without a stress response.”
Personalized weight loss treatment plans are key
At True You, we believe that a personalized weight loss treatment plan is essential to helping our PCOS patients feel heard, understood, and motivated to continue on their weight loss journeys. We work hard to find the right solutions for each unique patient, as well as the right combination of nutritional strategies that will work. Weight loss plans will depend on age, severity of PCOS symptoms, and overall health. Care is also based on whether or not the patient hopes to become pregnant in the future.
“At True You, each of our PCOS patients receives a weight loss program that best suits their personal needs,” adds Kathleen. “To determine the right mix of macronutrients, we look at things like how the patient responds to certain foods, their hunger and energy levels throughout the day, and whether their bodies are undergoing transformations. We listen carefully to what our patients tell us about their physical health, and we always make adjustments until we start to see those desired results.”
Does medication help?
Weight loss plans for PCOS patients may also include certain medications to help promote progress. Metformin is sometimes prescribed for PCOS patients to help the body use insulin better and promote a healthy weight. Medications for insulin sensitivity and androgen regulation may also be effective, depending on the patient.
“These drugs are not life-changing, but they can support our efforts,” Emily explains. “Overall, we want patients to know that we have a lot of experience working with PCOS and personalizing care. Women with PCOS can live normal and productive lives and overcome fertility obstacles if that’s the focus. We are here to support them in making lifestyle changes and finding strategies to minimize symptoms and achieve weight loss success.”