Have you struggled to lose weight despite eating a low-carb, low-calorie, low-fat, low-fun diet? No matter how much you exercise or restrict calories, you only lose a few pounds and then see your weight loss stall for no reason? Have you fought to lose weight only to see it quickly rebound back with even more weight than before you started? You are not alone. Weight loss resistance is one of the most frustrating aspects of PCOS. We are here to crack the code to losing weight with PCOS!

If you have been diagnosed with PCOS and you are above your ideal body weight then very likely your doctor has recommended you lose weight. Studies show that losing 10 extra pounds can significantly improve PCOS signs and symptoms, but this is by no means an easy task.  

The standard weight loss advice of “eat less and move more” is considered a first-line treatment for PCOS, with or without insulin-sensitizing medication. But despite adding medication to a program of moderate exercise and calorie reduction, the needle on your scale may not budge.

Why is it so hard to lose weight with PCOS?  

Contemplate these 3 reasons for weight loss resistance in PCOS. We delve into steps you can take today in this article.

1. All calories are not created equal.
2. Insulin resistance leads to weight gain.
3. Stress hormones tell your brain how much you should weigh.

All calories are not created equal

In 1977 the US Senate Committee on Nutrition and Human Needs developed dietary guidelines to  promote the “calories in, equals calories out” philosophy which says that all calories are created equal. The take-home message is that weight gain happens when you take in more calories than you burn each day. These guidelines jump-started the “low-fat, high-carb” nutrition pyramid that dominated nutrition weight loss advice for the past 3 decades. Fat (with higher calories per serving than carbs) was demonized and “low-fat” carbs began to take its place. These guidelines, however, were not based on any scientific evidence or well-conducted clinical trials. In fact, this nutrition advice had the opposite effect and led to epidemic rates of obesity in the US over the past 30 years.   

This low fat, high carb strategy is bad advice for most people but is particularly harmful for anyone with PCOS. The hormone imbalances that drive PCOS create weight loss resistance for the majority of PCOS sufferers. The reason is that the type of food you eat (carbs, especially processed carbs) has massive consequences for your metabolism and the hormones that control your metabolism, namely insulin and cortisol.  The experiment of “all calories are created equal” has been a dismal failure. Here’s why.

Insulin leads to weight gain

Insulin is a fat storage hormone and regulates energy metabolism. It is responsible for getting sugar out of your bloodstream and into your cells. This is important since your cells need sugar to make energy. The problem is when your cells no longer respond to insulin and won’t allow sugar inside. This is called insulin resistance and 70% of women with PCOS have this condition.

When you are insulin resistant your body needs to produce more and more insulin to get the sugar out of your bloodstream. If the cells in your body continue to ignore the insulin signal, then your only choice is to start storing sugar as fat. In fact, anything that consistently raises your insulin levels will make you gain weight. The reason that this problem is exaggerated in PCOS is because you are genetically prone to developing high insulin states. This is why the past 30 years of nutrition advice (low fat, high carb) is partly responsible for the rise in PCOS.

5 ways to lower insulin resistance

There are some simple ways to improve your body’s response to insulin. 

1. Reduce your carbohydrate intake

This especially means grain-based processed carbs. Although both protein and carbs (including grains, fruits, starchy vegetables, nuts/seeds, and beans) can bump insulin levels, processed carbohydrates do it way more effectively. Fat is the only macronutrient that does NOT raise insulin levels, so ditch the low-fat varieties of anything you eat. Aside from the huge insulin spike you get with processed carbs, anything flour-based like breads, pastas, crackers, chips, cookies, cakes, do not trigger feelings of fullness like other whole, fiber-rich, protein packed, fat containing foods do.  

2. Ditch the fatal four

Take stock of what you are actually drinking. Caffeine, alcohol, sugar, and artificial sweeteners can sneak their way into your favorite beverages to worsen insulin resistance. This is NOT just about the calories. The fatal four will wreak havoc on your stress hormone levels, your liver detoxification ability and wreck the beneficial bacteria in your gut that play a huge role in hormone balance.  

3. Stop snacking

Many of you have likely experimented with low carb diets and have noticed some but not a ton of weight loss. Perhaps you’ve barely lost any weight at all. When what you eat isn’t the answer, you have to consider when you eat. Each time that you eat, you raise your insulin levels. So if you eat 3 meals a day, you will bump insulin 3 times a day. Now add 2 snacks and you’ve got 5 insulin bumps a day. Add a bedtime snack and you are up to 6. You see the problem. Now if you have low blood sugar issues this is a sure sign that you are in fact insulin resistant and will need more guidance as to how to begin fixing your insulin load.  

4. Consider intermittent fasting

This is a technique we discuss in more depth in our course, the PCOS SOLUTION program. This may not be for everyone, but you can try to narrow your eating window to 12 hours, say 7 AM to 7 PM.  This means that you have your 2 or 3 meals of the day only during this 12-hour eating period. The 12 hour window of fasting (7 PM to 7 AM) helps to create a low insulin state. And low insulin means your body has a chance to tap into fat burning for energy.  

5. Balance your stress hormones

Insulin resistance and weight gain are not ONLY about what you eat. When stress hormones are constantly elevated or out of rhythm, you will not be able to lose weight. Clues that you have a stress hormone imbalance? You:

• Get less than 8 hours sleep a night, or your sleep is disrupted.
• Wake up tired despite sleeping well the night before.
• Are all work and little play.
• Feel anxious or depressed more often than not.
• Skip meals and/or overeat.
• Feel shaky, dizzy, nauseated or “hangry” when you skip meals.
• Feel tired and fatigued all the time, especially in the afternoon, or have to take an afternoon nap or chug down a double shot of espresso to keep your eyes open.
• Are tired after you exercise or are too fatigued to exercise at all.

Stress hormones tell your brain what to weigh

Let’s talk about the other key hormone in your body that can make you fat or thin, namely cortisol. Cortisol is a stress hormone that controls your “fight or flight” response. It sets into motion different physiologic actions to handle perceived threats. When cortisol is released, sugar becomes immediately available for emergency use (like, running away from a tiger or screaming at the car ahead of you for driving like an idiot).

This is all well and good if stressful events are fleeting and temporary. But when chronic stressors are at play, guess what happens to your blood sugar levels? They remain high. And guess which fat storing hormone is constantly triggered to fix these high levels? You guessed it, insulin. So this is why even when you are eating low carb and exercising a lot, you cannot lose weight.  

Chronically high cortisol levels create 2 huge problems. First, it raises insulin levels, and we now know that high insulin levels make you fat. Second, chronic stress lowers your metabolic rate when energy expenditure goes up. This means that trying to restrict calories or exercise more while you are under stressful conditions will trigger a drop in metabolism as your brain looks to conserve energy in the face of perceived stressors.  

why Stress hormones become imbalanced

1. Dietary stressors: sugar, processed foods, alcohol, caffeine, low vegetable and fruit intake, low healthy fat intake, low fiber intake.
2. Physical stressors: traumas, surgeries, sleep deprivation, inflammatory states like irritable bowel syndrome, chronic neck, back or joint pains, migraines, arthritis, gastritis and reflux, chronic pain conditions, nutrient deficiencies.
3. Toxic exposures: pesticides, unfiltered water, chemicals, plastics, heavy metal exposure, air pollution, etc.
4. Emotional stressors: high stress related to work issues, financial difficulties, relationship issues, death or illness in the family, being a caregiver, experiencing anxiety or depression.

steps to normalize stress hormones

We dive deeply into this subject in our 6-week program. For, now, here are 4 essential steps to consider:

1. Clean up your nutrition

Eat an anti-inflammatory, nutrient-dense, insulin-balancing diet. Avoid processed, sugar-laden fake foods with no nutritional value, that only serve to bump insulin levels. We dive into PCOS-specific recommendations in our PCOS SOLUTION program.

2. Master your sleep

8 hours of quality sleep are critical for weight loss. Studies show that getting 7 or less hours of sleep a night is associated with weight gain. Often when we get women to sleep well, that’s when weight loss happens. Sleep well to lose weight!

3. Do the right exercise for you

Are you over-exercising? You may be increasing your stress hormones too much, especially with extended cardio. Interval or burst training creates a better hormone milieu for weight loss. Or, are you under-exercising? Find the sweet spot to improve rather than damage your metabolism.

4. Practice mindfulness

Your parasympathetic nervous system is your “rest and digest” pathway. This is all about slowing down, calming your brain, and relaxing your body. Yoga, tai-chi, meditation, and walking in nature are all great tools to create peace and calm. We dive into these techniques and more in our 6-week program to reverse PCOS.

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Don’t go this alone.

Let us lead you through our successful, step by step approach to fix the underlying causes of PCOS. Learn to balance your hormones, lose weight and feel great in 6 weeks! Check out the first Functional Medicine program to reverse PCOS.