Do you have polycystic ovary syndrome (PCOS) and suffer from stubborn weight gain? Have you tried numerous diets but still cannot lose the excess weight? Weight gain is one of the most common symptoms associated with PCOS.

PCOS is a common condition which is thought to affect 1 in 10 women in the UK.

The exact cause of PCOS is unknown, however there are two dominant features;

• high levels of androgens (male hormones) such as testosterone
• high levels of insulin.

Symptoms of PCOS include;

• Irregular periods (or none at all)
• Difficulty in getting pregnant
• Excessive hair growth
• Weight gain
• Hair loss and thinning hair
• Oily skin
• Acne (especially on the chin)

Medical Approach

If you have any of the above symptoms then it may be worth checking in with your GP who can investigate further. They may perform blood tests to measure levels of hormones, including testosterone, luteinizing hormone, follicle stimulating hormone, prolactin and thyroid stimulating hormone. A referral may also be made for an ultrasound.

If you receive a diagnosis of PCOS, metformin is prescribed in some cases. This is traditionally a drug to treat type 2 diabetes but can also lower insulin and blood sugar levels in PCOS. If fertility is an issue you may be offered drugs to stimulate ovulation. There are also medications on offer to treat other PCOS related symptoms such as acne and hair loss.

Contributing factors

Insulin Resistance

Up to 70% of women with PCOS have insulin resistance. Insulin is a hormone in the body which controls blood sugar levels. When insulin resistance occurs, the cells in your body are less sensitive to insulin. The body compensates for this by producing more insulin which leads to high levels.

High insulin levels often seen in PCOS can impair ovulation, causing your ovaries to make testosterone instead of oestrogen. It can also cause your body to produce increased levels of luteinizing hormone (LH) which stimulates your body to make excess androgens.

Too much insulin can also reduce levels of sex hormone binding globulin (SHBG) which androgen hormones bind too. Reduced SHBG levels can result in an increase in circulating levels of unbound or free testosterone.

These high levels of androgens disrupt the menstrual cycle and lead to many of the symptoms experienced by those with PCOS.

Inflammation. There is a strong association between PCOS and chronic, low grade inflammation within the body. Inflammation is your immune systems response to viruses or injury. However, chronic inflammation is when the bodies inflammatory response continues. This is often seen in autoimmune conditions and can be caused by other reasons such as diet, lifestyle, obesity, oxidative stress and psychological stress.

Weight gain. Up to 75% of women with PCOS are overweight. For these women it can feel much harder to manage their weight as high insulin levels signal to the body to store fat, leading to weight gain. Being overweight then increases the amount of insulin that your body produces. High levels of insulin can also increase hunger and carbohydrate cravings which can contribute further to weight gain.

Being overweight can contribute to the development of PCOS and exacerbate symptoms. It was found that those who were overweight and managed to reduce their weight by 5% saw an improvement in many features of PCOS.

Nutritional Therapy for PCOS

Although this can all sound a bit overwhelming, the good news is that there is a lot of evidence out there regarding the role nutrition can have in managing associated symptoms. By working together, we identify what your health goals are and put a bespoke plan in place for you which includes ongoing advice and support, this may also include testing if deemed appropriate. Below are just some of the areas that we may focus on.

Eating a diet rich in plant-based foods, nuts and legumes. Anti-inflammatory,full of fibre and rich in phytochemicals,these foods have been associated with an improvement in insulin resistance and obesity in women with PCOS. Fibre not only promotes blood sugar balance but is great for our gut health. It aids digestion, the absorption of nutrients and assists with the excretion of excess testosterone.

Eating foods that have a low glycaemic index/glycaemic load. This helps to control blood sugar levels and consequent high insulin levels. Eating complex carbohydrates from unrefined foods has been linked to greater insulin sensitivity.

Ensuring adequate protein with each meal promotes blood sugar control and increases levels of fullness after a meal.

Reducing sugar and processed foods. Reducing or eliminating sugar and processed foods from your diet will help balance blood sugar levels and can help reduce inflammation.

Omega 3 fatty acids. Found in foods such as oily fish, nuts and seeds, omega 3 has been found to have a beneficial effect on improving insulin sensitivity and helping to reduce inflammation within the body.

Lifestyle. Lifestyle changes can play a large part in the management of PCOS. The right kinds of exercise can be hugely beneficial for sensitising your muscle to insulin and weight loss. Stress management is crucial as stress can lead to dysregulated blood sugar levels and weight gain. Yoga, mindfulness, meditation are just some strategies to consider. Optimising sleep is also important as this too can impact our weight.

Environmental toxins. Women with PCOS have been found to have higher BPA levels, which correlate with higher androgen levels and insulin resistance. Therefore, we need to think about limiting exposure to these types of every day toxins where possible.

Cinnamon. Cinnamon is a natural insulin sensitizer, it acts like metformin, stimulating glucose uptake by fat cells. You don’t need masses of the stuff! Just ½ teaspoon per day.

Targeted supplements. Magnesium, Vitamin D, Ashwagandha and Myo-inositol are supplements that may be beneficial in some cases however please seek advice before commencing any supplementation.

If you’d like to know more about how I can support you with PCOS then please do get in touch.