PCOS & Your Weight: What You Need To Know

Updated: Aug 5, 2022

Happy PCOS Awareness Month 💜

There are so many false beliefs when it comes to PCOS & your weight:

❌You have to be overweight to have PCOS.

❌Your weight “caused” you to get PCOS.

❌You can’t lose weight if you have PCOS

None of this is true!

Since January 2021 I’ve been a featured speaker in the PCOS Weekly Room in My Dynamic Uterus Club on Clubhouse. The My Dynamic Uterus Club is the largest pregnancy and fertility club on Clubhouse with more than 15K members. It was started by Dr. Cindy Duke, America’s Only Dual Fertility Doctor and Virologist. Dr. Cindy has connected a multifaceted team to discuss PCOS weekly which truly encompasses the complexity of PCOS. The MDU PCOS Weekly moderators are doctors, fitness experts, nutritionists, mental wellness champions, and PCOS advocates . Each week we address PCOS misconceptions and overall wellness by answering questions from PCOS warriors in the audience.

I love serving as the weight and wellness physician expert in MDU. I am passionate about this role and schedule time each week to join the PCOS room because

PCOS is the most common hormonal condition in reproductive age women but often misdiagnosed, overlooked, & under-treated.

Honestly, we did not learn much about PCOS in medical school. Most of my PCOS education occurred after medical school as I’ve worked with PCOS warriors throughout my 🔟years in Internal Medicine.

In my 5️⃣ years as an obesity specialist & wellness expert, I often diagnose PCOS after women have suffered from PCOS for many years without a diagnosis and now have non-reproductive effects of their PCOS such as insulin resistance, obesity, metabolic syndrome, high blood pressure and type 2 diabetes. PCOS has also been associated with heart disease.

This is why I am so passionate about raising PCOS awareness and addressing PCOS so that women get timely treatment of PCOS in from a “whole person” approach. I firmly believe PCOS and its treatments don't define you but help enhance your life enjoyment. That’s part of why I’m so excited to be speaking about “Overcoming PCOS Weight Misconceptions” at the inaugural That PCOS Support Retreat hosted by Shelby Eckard (PCOS Support Girl) on Saturday September 3rd, 2021.

Let’s talk about “Overcoming PCOS Weight Misconceptions”

Misconception One

❌You have to be overweight to have PCOS.

This is a common misconception and honestly bias that many clinicians have. Actually diagnosis of PCOS is:

A diagnosis of exclusion, which means other disease conditions must be evaluated before you can diagnose PCOS.
The clinical criteria for diagnosing PCOS is having 2 of 3 clinical features:
- Laboratory or clinical evidence of high androgens (i.e. hirsutism-hair on face, chest, and back, High testosterone levels, etc )
- Unpredictable or lack of menstruation ( “Oligomenorrhea or anovulation”)
- Radiographic evidence of polycystic ovaries (Large follicle >10ml or more than 12 follicles 2-9mm in size)

Rotterdam Criteria, 2003

What’s “missing“ in the criteria? Notice that there is NO mention of weight, BMI, or waist circumference in the PCOS diagnostic criteria.

In fact 20-40% of women with PCOS will not be overweight by the current standards of diagnosing obesity (BMI >30kg/m2 or Waist Circumference >35inches or 88cm).

However it is important to note, regardless of your weight if you have that you are still at risk of the metabolic conditions associated with PCOS due to high androgen levels and insulin resistance. Insulin resistance will impact 40% of people with PCOS. Insulin resistance can put you at risk for obesity, metabolic syndrome, type 2 diabetes and heart disease.

Misconception Two

❌Your weight “caused” you to get PCOS.

While there is an association between the medical condition of obesity and PCOS, obesity does not directly cause PCOS. This is evident since most people with obesity do not have PCOS.

In fact it is the opposite, the hormonal changes associated with PCOS can actually cause obesity. Being diagnosed with PCOS and insulin resistance increases your risk of developing obesity (defined as BMI >30 kg/m2 in the studies that researched PCOS and obesity risk). Unlike previous understandings of body weight and obesity we now know that Your Healthy Weight is determined by more than just the BMI cut off of >30kg/m2. In Embrace You we use a more individualized approach to determining Your Healthy Weight beyond the standard BMI tables.

Misconception Three

❌You can’t lose weight if you have PCOS

It can be frustrating trying to lose weight when you have PCOS, especially if you aren’t given the right guidance. The old dieting weight loss model of “calories in” vs “calories out” can actually be harmful for PCOS.Why? For many reasons:

-Quality of food is more important than quantity of calories: Due to insulin resistance we know that people with PCOS insulin resistance are more sensitive to foods high in sugar and refined carbohydrates. Ironically you may crave these foods because your body isn’t able to use the glucose (or breakdown product of sugar) very well. This leads to a vicious cycle of insulin release which worsens insulin resistance and drives weight gain. That is why optimizing your nutrition in PCOS is so important.

-Changes in appetite: Ghrelin, the “hunger hormone”, released from gastric (stomach) cells tell the brain you’re hungry. Normally ghrelin decreases after you eat but in PCOS patients ghrelin remains elevated higher than expected after eating. This leads you to feel hungry and unsatisfied with your meals.

“Energy In” vs ``Energy Out”: We know now that body weight regulation or more specifically body fat regulation depends much more than calories but actually “energy in” vs “energy out.” PCOS impacts your energy balance in many ways that can affect your energy beyond your plate or in the gym. The impact of PCOS on your mood, relationships and other aspects of your life can also have an impact on your weight.

Despite all these factors it’s not impossible to lose weight with PCOS. However your weight plan has to address all the factors contributing to your energy imbalance and fit into your lifestyle. Traditional dieting forces you to focus on the scale. However your life is more than the scale so your weight and wellness plan has to look beyond the scale, calorie counts and gym workouts you can’t stand. My bestselling book, Embrace You: Your Guide To Transforming Weight Loss Misconceptions Into Lifelong Wellness, equips you with your individualized strategy for your wellness based weight and wellness journey. It also helps you to identify your team for managing your PCOS weight loss journey.

Wrap Up

PCOS is just a condition that you have. It is not who you are. Your weight is just data. It is not who you are. You will hear many things about weight and PCOS. I hope this blog post has helped you:

Release-

❌You have to be overweight to have PCOS.

❌Your weight “caused” you to get PCOS.

❌You can’t lose weight if you have PCOS.

Embrace

✅You can have PCOS at any weight.

✅You are not to blame for your PCOS.

✅You can be whole & healthy with PCOS.

Are you tired of obsessing over the scale, struggling with your weight & doubting if you can make a consistent change? If you want clarity on:

⭐️how to overcome your unique weight gained triggers &

⭐️ confidently use your personalized Body-Mind-Spirit weight & wellness strategy with individual & group coaching, the 1️⃣2️⃣week Embrace You Weight & Wellness program has your solution for your weight & wellness breakthrough.

💜Limited enrollment to our Fall session ends September 6, 2021. Schedule your complimentary consultation now before we fill up- currently 60% full.