How to lose weight with PCOS: Your questions answered

• PCOS causes hormonal imbalances—which increase your chances of weight gain
• Manage your weight by making small, sustainable diet and lifestyle changes
• Most important are making sure you find nutritious foods and let go of unhealthy eating habits

If you’re among the millions of people with polycystic ovarian syndrome (PCOS), you probably know more about the importance of weight loss than most.

Losing weight while dealing with PCOS often feels like an uphill battle. 

PCOS makes it challenging to lose weight—and as a double whammy, weight gain can worsen your PCOS symptoms.

We spoke to Dr. Noy Phimphasone-Brady, Ph.D.—a clinical health psychologist specializing in type 2 diabetes, weight management, and PCOS—about how to lose weight with this complex condition.

Why is it hard to lose weight with PCOS?

According to Dr. Phimphasone-Brady, the two factors that make it difficult for people with PCOS to lose weight are hyperandrogenism and insulin resistance.

PCOS causes hyperandrogenism (increased androgens, or sex hormones). That means increased testosterone “plus a whole host of other hormones that are out of balance,” which can increase the risk of weight gain, the doctor said. This is also what causes hirsutism—or excess hair growth—and menstrual irregularities.

And people with PCOS are often insulin resistant, so they have higher blood glucose levels. High blood sugar increases the likelihood of gaining weight because excess glucose is stored as body fat.

What is the best way to lose weight with PCOS?

Don’t force yourself to follow a restrictive weight loss program. 

Highly restrictive diets are not sustainable and can lead to overeating—creating an endless cycle that many people with PCOS are all too familiar with.

The best way to lose weight with PCOS is to make lifestyle modifications that work for you.

While your health care provider can help you come up with a PCOS management plan, there’s no special rulebook when it comes to losing weight with the condition.

You’ll use plenty of common weight loss tactics, but the trick is to take a long-term approach that isn’t about losing weight quickly–but losing weight sustainably.

Note: Consult with your health care provider before making dietary changes.

Maintain a calorie deficit 

To lose weight–with or without PCOS–you need to be in a calorie deficit, meaning you burn more calories than you consume.

Every body is different, and your caloric needs depend on several factors such as age, height, weight, and activity level. 

But say, for example, your body burns 2,000 calories per day. Limiting yourself to 1,500 calories would create a deficit of 500 calories. 

In place of those missing calories, your body burns fat, which leads to weight loss. 

But focusing on cutting calories can sometimes cause people to restrict themselves in unhelpful ways. 

Here’s what we mean: 

You might create a calorie deficit by eliminating carbs completely from your diet and lose weight for a little while. 

But it’s not realistic to say you’ll never eat bread again. Placing rules around food can increase the risk of overeating–and the cycle starting all over. 

For sustainable weight loss, make small changes that you can maintain long-term: 

Instead of telling yourself you can never have bread again, tell yourself that you’ll only have bread once a week or switch to an alternative with a low glycemic index. 

Focus on low-caloric density foods

While no foods are inherently “good” or “bad,” some (like ice cream) are just more calorie-dense than others.

So while a scoop of ice cream may have around 200 calories, it doesn’t have a lot of nutrients to fill you up. 

On the other hand, a low-caloric density snack like an apple is full of fiber, which increases satiety (and only has about 100 calories).  

When you focus on low-caloric density foods, you can eat more while maintaining a calorie deficit–which means you won’t feel hungry. 

Noom Weight uses a three-color system that helps you choose the most nutrient-dense (and least calorie-dense) foods:

• Green foods have the lowest caloric density (think fruits, veggies, and whole grains)
• Red foods have the highest caloric density (think ice cream or cheeseburgers)
• Yellow foods fall in the middle (think lean meats, rice, and healthy fats) 

At Noom, we want you to enjoy all kinds of foods–so green doesn’t mean “go” or “good” and red doesn’t mean “stop” or “bad.” Rather, the color indicates how much of each food you should eat to stay within your calorie budget. 

When you fill up on green foods, you can indulge in a scoop of ice cream now and then with no regrets. 

Track your food intake

Studies indicate that monitoring your food intake can help with weight loss, and there’s a simple reason: When you track your food, you see how much you actually consume.

According to a Cornell study, people underestimate their calorie intake by 20–40% when they don’t track their meals. But with time and practice, food logging will show you what proper portions look like.

“Food monitoring is a really good intervention,” said Dr. Phimphasone-Brady, “because it helps you see where you can make changes.”

Each meal you log is a learning opportunity—to see where you’re taking in calories and decide whether that food is what you want to fill up on.

A good food-tracking app (like Noom’s) can make it easy by calculating your calorie intake for you.

All you have to do is enter the food you want to eat, and how much of it you want to eat, and you’ll see exactly how many calories are in that item and how it fits into your daily calorie budget. 

You’ll also see whether a food is categorized as green, yellow, or red. 

The app includes a large database of foods, so for most meals you can simply start typing and it will bring up a menu of options to choose from. 

It also comes with a barcode scanner, so you can log prepackaged foods by just scanning the barcode. 

Understand your eating habits

Do you find it hard to say no to breadsticks once they land on the table or a box of doughnuts in the office? 

Those are triggers.

When you know what your triggers are, you can plan to get ahead of them. You might fill up on salad before grabbing a breadstick, for example, or eat a nutritious breakfast before heading into the office.

That’s why Noom offers short, digestible daily lessons based in psychology that help you understand why you make certain food choices and overcome the triggers and thought distortions that prevent you from losing weight. 

Dr. Phimphasone-Brady advises her patients with PCOS to engage in mindful (or intuitive) eating, which means you focus on your experiences and pay attention to hunger and fullness cues. 

She offered a few fundamentals for mindful eating:

• Eating when you are physically hungry
• Eating slowly, without distractions
• Eating only until you are full

But there will be days when you cave into the bread basket, even if you’re not particularly hungry—and that’s okay. 

When you understand that slip-ups are part of the journey, they’re less likely to derail your progress.

Build exercise into your routine

Exercise is not a requirement for weight loss, but it can help decrease insulin resistance and lessen some symptoms of PCOS.

If you aren’t currently active, don’t sign up for next weekend’s 5k just yet. When you jump into a rigorous exercise regimen, you’re more likely to burn out (or injure yourself).

As a starting point, Dr. Phimphasone-Brady recommends just focusing on being less sedentary, then gradually adding more movement into your day.

You could set a goal to walk 200 steps tomorrow, 300 steps the next day, and so on. After a while, you might find yourself walking a few miles a day.

If you find walking boring, keep exploring other physical activities—like yoga, dancing, biking, or kayaking. You’re more likely to look forward to exercising if you have an activity you enjoy.

“It’s very person-specific,” said Dr. Phimphasone-Brady.

What are the best foods for PCOS weight loss?

There is no specific diet for people with PCOS, but Dr. Phimphasone-Brady recommends her patients focus on whole foods that reduce inflammation to help manage their symptoms.

She suggests eating in a way that’s “more in line with the Mediterranean Diet,” focusing on foods like:

• Lean protein (like chicken breast)
• Fruits and vegetables
• Whole grains
• Healthy fats (like avocado)

Refined carbs, sugary drinks, and fried foods, on the other hand, increase inflammation and should be limited.

Can PCOS go away with weight loss?

“PCOS doesn’t go away,” said Dr. Phimphasone-Brady, but it is possible to get to a place where your symptoms are less bothersome.

Exercise and weight loss can lower insulin resistance, which is a primary symptom of PCOS.

Most importantly, keeping your insulin levels in check can help people with PCOS prevent future problems that they are at an increased risk for, like type 2 diabetes and heart disease. Talk to your medical provider about medications for treatment of PCOS that could help with maintaining a healthy weight. 

Start losing weight with Noom

With our food tracker, three-color system, and daily lessons based on psychology, Noom Weight can help you make healthy food choices and sustainable behavior changes to lose weight in the long term.

Learn more here about how Noom works for women with PCOS.