Why can PCOS make us gain weight?
Okay buckle up for our favorite topic, kids! Kidding. This is a rough one. It hits close to home for so many of us. We grew up feeling like the odd ones out, not quite understanding why we couldn’t eat the way many of our friends did without the repercussions. Maybe our grandmothers poked our stomachs or rubbed our bellies giggling at how “chubby” we were. Maybe our uncle’s dreadful wife referred to us as the “fat one” in the family photos at our grandfather’s funeral. Or maybe you can remember the boys in your class starting to call you “fat” when you were as young as 5 years old…
PCOS Impact on Weight Loss
Okay, sorry, I digress. As I was saying, quite a few of us live with this reality every day. PCOS can have an impact on weight - on our ability to lose it, maintain it - you name it. For many of us it can feel like we practically have to starve ourselves to lose a half of a pound, and even eating 1000 or 1200 calories doesn’t work to make the number on the scale go down. Well, first, take comfort in the fact that you are not alone here. This is extremely common in individuals with PCOS, and you should not scold yourself for it. There are actual internal factors at play that make it difficult for us to shed pounds. And, I know it sounds counterintuitive, but a lot of the time, the problem is actually that we are depriving ourselves too much to the point where we sabotage our own weight loss efforts.
I’m getting ahead of myself.
You wanted to understand why PCOS has an impact on your weight.
So let’s get to it.
Insulin Resistance
If you’re like me, if you never see the words “insulin resistance” again in relation to your PCOS, it will be too soon. We’re constantly hit over the head with it. But the reality is there’s a reason - if we have it, it can contribute to a lot of our symptoms, and the long-term effects of PCOS. So let’s break it down simply: insulin is a hormone. It allows glucose to enter our cells to provide us with energy. Humor me, insulin is the bouncer outside of the club responsible for not letting too many people in at once. The bouncer is protecting us from too much glucose - preventing a fire hazard, if you will. Making sure that we get JUST the right amount of glucose for energy.
However, when we are insulin resistant, the club bouncer is on a power trip. Someone gave him a walkie-talkie and he has let this power go to his head. He’s not letting ANYONE into the party, and the club owners are now pissed because now how will they charge $22.50 for a watered down vodka soda?! AKA - our insulin is not letting enough glucose into our fat and muscle cells. So we have NO energy. And that sucks, but our bodies are designed to jump into survival mode. The owners of the club send multiple new bouncers to quickly let the ever-increasing line of patrons into the club as quickly as possible. Or, we start to overproduce insulin to make sure the glucose we need gets to our cells, and we have the energy we need to get through the day.
But we can’t keep this up forever. Eventually our bodies cannot produce enough insulin to allow the glucose into our cells. All the bouncers in the club have gone on the same power trip. The line is ever extending, and the club is empty. The glucose is not reaching our fat and muscle cells, and instead it’s hanging out in our bloodstream. So it’s like our fat and muscle cells have no idea there’s glucose in the blood they could use for energy. It triggers hunger, because the fat and muscle cells are not receiving the energy needed for typical function, and we eat more, contributing to higher and higher levels of blood sugar.
The line at the club keeps getting longer and longer, and the patrons have nowhere to go! They spill out into the streets and wrap around sidewalks. So, that excess sugar in our blood has to go somewhere if the liver and muscle cells aren’t taking it in. It has nowhere to go, other than to be stored as body fat. And so insulin resistance creates this vicious kind of cycle for us to gain weight.
So how can we piss off the club bouncer?
How can we make him so annoyed that he is sure not to let us in?
That we’re sure glucose will not get to our muscle, liver and fat cells for healthy function?
Undereating
Hi, hello, I’m talking to you there only eating 1,000 calories per day. I learned the HARD way this only makes things worse. Insulin is our bouncer, right? Insulin makes sure we not only process what’s entering our bodies, but also that we’re storing the excess for when our bodies might go into starvation mode (think of the line building up outside the club - he wants reserves to go to when people leave the club so the owners are happy with him constantly feeding in patrons of the $22.50 vodka soda). This goes back to the days of famine, of hunting and gathering. You’re going to make your body think food is scarce, that it needs to hold onto every morsel and store it as fat to use for energy later. Don’t do it. You’re going to piss off the bouncer.
Increasing Cortisol Levels
Hi, is that you?! Wow, you REALLY want to assert your presence today don’t you? You are just off the charts. Historically, elevated cortisol levels were used for “fight or flight”. Maybe a lion was chasing us, maybe there was a famine. I don’t know. Anyway, excess cortisol indicates to the body we’re in survival mode. Cortisol acts to give us the quick burst of energy we need to run like hell away from the lion chasing us. Guess what that quick burst of energy is? Yup, you guessed it. Glucose. More glucose flooding into our bloodstream, contributing to the excess. Ain’t nobody getting into the club now!!
Inflammation
Chronic inflammation is very common in PCOS. It’s another way for us to piss off the bouncer where he won’t let us glucose molecules into the club. The more inflamed we are, the less sensitive we are to insulin. Glucose once again is unable to enter our cells, contributing to further insulin resistance.
Okay, now I’m overwhelmed. What the heck do I do?
It can feel like there is a lot working against us contributing to difficulty losing weight. Add on top of all of this the fact that we tend to have elevated levels of testosterone, and it can lead to abdominal weight gain, or the “dad bod” look. This abdominal weight may be increasingly stubborn if we do not get our testosterone back into an optimal range. I hope this helps to show how important it is to modify your lifestyle. It’s not just about holding onto excess weight, although it’s something that occupies many of our minds. It’s so much more than just weight. It’s about our health, it’s about preventing the long-term health complications that come from insulin resistance, chronic stress, inflammation, and more.
So what are some of the key principles we can apply?
Get enough sleep: Do not underestimate the power of sleep, folks! Aim for what makes you feel good, 7-9 hours. Sleep releases healing hormones that allow us to properly digest our foods. Research has also shown that females are more likely to experience cravings after a poor night’s rest, suggesting that sleep worsens insulin sensitivity.
Manage your stress levels: I know, easier said than done. Hustle culture, political and social unrest, a lil’ panorama that’s been disrupting our lives for a while now…But just start to try and move the needle here. Experiment with practices that work well for you and prioritize them. Self care is not selfish! Increasing our cortisol levels will only feed a vicious cycle of poor blood glucose metabolism, insulin resistance, fat storage, sluggish energy levels, etc. We want our cortisol to help us be more resilient in times when we really need it!
Do not undereat, do not over exercise: Just don’t do it. It’s terrible on so many accounts and is going to destroy your hormonal balance. Eat to nourish, not to restrict. Eat to give your body the fuel and nutrients it needs to get you on track. Exercise to move your body, feel joy, reduce stress, increase blood flow and oxygenation, improve concentration, etc. Reframe your mindset. Exercise and body movement are about so much more than weight. Find what you enjoy, and prioritize that.
Limit processed fats, refined sugar or grains, alcohol, processed foods: That’s right! Nutrition. It can make or break our cortisol levels, our inflammation, contribute to our insulin sensitivity, the energy we have to exercise, and so much more. Opt for whole foods when you can. Natural fats, high fiber carbohydrates, and veggies will never do you wrong. Opting for organic can help as well. This can get expensive, so try to follow the “Dirty Dozen” rule to know which fruits and veggies are sprayed with the most chemicals or are most susceptible. Prioritize these for purchasing organic if you can. If you’re buying frozen, choose only frozen fruits and veggies where the ingredient is only that. You don’t want added sugars, chemicals, preservatives, etc.
Avoid excessive amounts of caffeine: Limiting things to one cup of coffee per day is a safer bet if you can do it. It helps with managing proper levels of cortisol. This will also help you with sleep regulation. And, when you do have caffeine, try to pair it with a meal, like a high protein breakfast, to achieve optimal glucose regulation throughout the day.
Balance your meals: Balancing our meals and snacks with high fiber, protein and fat is an awesome way to stabilize our blood sugar levels and improve insulin sensitivity.
Opt for meals low on the glycemic index scale: High glycemic index foods and meals consumed too often can lead to a dysregulation of the hormone glucagon, insulin’s counterpart, that serves to counteract insulin if blood sugar is low and increase glucose levels in the blood. Glucagon also plays a key role in fat storage, and if thrown out of balance, glucagon can trigger fat storage when it doesn’t need to. Prioritizing low glycemic index foods is so important to help glucagon get back to its healthy state!
Get enough protein! One of the biggest transgressions is not getting enough protein. Try to start your day with a high protein breakfast (25-30g of protein) and strive to get up to 100g of protein for the full day.
Get your fiber: Fiber is a miracle macronutrient! Aiming for 25-30g a day helps immensely with slowing down how quickly glucose from our food enters our bloodstream, and also helps our body to stay on track to digest and eliminate what we don’t need.
Get your cinnamon! 1 tbsp. of cinnamon per day, added to smoothies, oatmeal etc., has been shown to help greatly with blood sugar stabilization
Relax with tea: Green tea, cinnamon tea, chamomile tea. All can help with blood sugar stabilization
Walk after meals: Just a 10 minute walk after your meals can help your body become more sensitive to insulin and help it avoid big blood sugar spikes