Medically reviewed on April 21, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Polycystic ovary syndrome (PCOS) is a genetic health condition that’s categorized by unusually long periods in women and individuals assigned female at birth (AFAB). Conversely, those with PCOS also may not have periods frequently. 
This occurs as a result of small cysts, or fluid-filled sacs, that develop on the outside of the ovary, which can disrupt the menstrual cycle. That said, this condition is often exacerbated by obesity and PCOS can cause insulin resistance, which may lead to weight gain. 
In this article, we’re exploring everything there is to know about PCOS weight gain and how to manage it.
PCOS is a genetic hormonal disorder that affects those of reproductive age. While PCOS does run in families, the exact genes involved in the development of PCOS are still not fully understood. However, researchers have identified several genes, including: 
These genes are related to one of the primary PCOS symptoms: high levels of androgens.
ndrogens are sex hormones that help jumpstart puberty and facilitate growth and reproduction. Men or people assigned male at birth produce high levels; they’re only found in low levels in women or AFAB (testosterone is the most common androgen). 
In men or for people with male sex organs, androgens are produced in the testicles. In women or people with female sex organs, androgens are produced in the ovaries. 
In effect, women or people AFAB who experience high levels of androgens can experience hyperandrogenism, a condition that’s closely related to PCOS. As a result, pre-pubertal girls and AFAB with hyperandrogenism and PCOS may experience: 
As girls and people AFAB age and enter puberty, the symptoms of hyperandrogenism can evolve. In addition to acne, oily skin, and excess body hair, elevated testosterone levels may also contribute to: 
However, hyperandrogenism isn’t the only symptom of PCOS. PCOS can also affect the production of another hormone: insulin. 
Insulin is produced by the pancreas, regulates blood sugar levels, and helps the body convert food into energy.  More specifically, it moves glucose found in your blood to various cells throughout the body to fuel bodily processes.
However, PCOS can cause insulin resistance, which occurs when the cells in your muscles, fat, and liver become resistant to insulin and are unable to easily use the glucose from your blood. 
As a result, high levels of insulin remain in the bloodstream, which can lead to an overproduction of testosterone and the development of cysts on the ovaries. 
High insulin levels can also contribute to weight gain: When the body is unable to convert glucose into energy, it instead stores the sugar as fat. 
PCOS may also cause: 
The symptoms of PCOS will often occur when an individual experiences their first menstrual period. PCOS affects five to ten percent of women and people AFAB. Accordingly, PCOS can appear in individuals as young as 11 years old. 
Polycystic ovary syndrome is associated with weight gain, particularly around the abdomen, but not all women or people AFAB with PCOS will experience weight gain. 
PCOS is also interlinked with obesity, a disease categorized by an excess of body or belly fat. Those with a body mass index (BMI) over 30 are typically considered to be obese, which is calculated based on your height-to-weight ratio. 
BMI, on the other hand, does not account for changes in body composition, such as muscle mass against fat mass.
Another issue with BMI is that it may not accurately reflect differences in health risks between different racial and ethnic groups. Studies have shown that people of Asian descent, for example, may have a higher risk of health problems such as type 2 diabetes and heart disease at a lower BMI than people of other racial and ethnic groups. 
So, be sure to speak with your healthcare provider if you think that your weight gain is a result of PCOS or if you believe you are obese. They may do a more thorough evaluation of your health and weight-related concerns, as well as establish a treatment plan suited to your needs.
PCOS weight gain can be especially difficult to control since the hormonal imbalances linked with the condition can make losing weight via diet and exercise alone more difficult. So, how to lose weight without dieting?
Certain medications and lifestyle adjustments can help improve insulin sensitivity and hyperandrogenism, as well as lessen PCOS symptoms such as weight gain.
Similar to type 2 diabetes and obesity, PCOS is considered to be a complex genetic trait. 
In other words, those with mothers or sisters with PCOS and PCOS-related weight gain are more likely to experience the condition themselves, too. That said, PCOS can also be inherited from the father’s side of the family. 
Managing PCOS weight gain can be challenging, but it’s essential to reduce the risk of developing other obesity risk factors or health problems such as diabetes, heart disease, and sleep apnea. While there is no cure for PCOS or PCOS weight gain, there are a few methods that you can implement to minimize its impact on your overall health.
Women and people AFAB who are not trying to conceive can use oral contraceptives to help balance out their hormone levels and make their menstrual cycle more regular.  Surgery, medications, and radiation therapy may also help treat hormonal balances. 
However, some believe that you can balance your hormones naturally, without medical intervention. For example, eating more protein can decrease the hunger hormone, ghrelin, and stimulate other hormones, such as glucagon-like peptide-1 (GLP-1), which help curb appetite and facilitate feelings of fullness. 
It’s also believed that gut health is largely linked to insulin resistance as well as feelings of fullness. Essentially, the gut microbiome produces short-chain fatty acids called acetate and butyrate, which can aid weight management and increase GLP-1.  To improve your gut bacteria, consider adding fermented foods or pre/probiotics to your diet.
A well-balanced diet is a crucial factor in managing weight gain in PCOS. Incorporate low-glycemic-index carbohydrates that are rich in dietary fiber. Focus on eating whole, unprocessed foods such as fruits, non-starchy vegetables, lean proteins, seeds, nuts, legumes, and whole grains. 
Additionally, avoid processed and sugary foods, as well as saturated and trans fats, which can contribute to weight gain and insulin resistance. 
Physical activity has been shown to improve insulin sensitivity and encourage glucose uptake, which may help those experiencing PCOS weight gain as a result of insulin resistance.  Strength training, also known as resistance training or weightlifting, can also help build muscle mass, which can also help insulin deliver glucose to cells throughout the body. 
A study also found that intense cardiovascular exercises can improve glucose metabolism and help facilitate PCOS weight loss.  All that said, it’s generally recommended to engage in at least 150 minutes of moderate intensity aerobic exercise or physical activity a week, or 75 minutes of vigorous activity.
Aerobic activities aim to increase your heart and breathing rate and include running, biking, swimming, and walking. Additionally, you should incorporate strength training into your workout routine twice a week to help encourage weight loss. 
Ask your healthcare provider about certain medications To control insulin resistance, many healthcare providers will prescribe metformin, an anti-diabetic medication that can treat high blood sugar levels, thus decreasing the amount of glucose available to convert into fat. Since it is a diabetic medication, some healthcare providers will only prescribe metformin to women or people AFAB that are diabetic or pre-diabetic.
There are also certain medications that can treat infertility that may occur as a result of PCOS. More specifically, these medications induce ovulation, which releases a mature egg from the ovaries and to the fallopian tube. Two medications that are commonly used for this purpose are Clomiphene citrate, sold under the brand name Clomid, and Letrozole, sold under the brand name Femara.
When your body experiences high levels of mental or emotional stress, it releases two hormones: cortisol and adrenaline. While these hormones can help your body react to a potentially life-threatening situation, they can also contribute to insulin resistance. 
To take the pressure off, consider mindfulness activities, such as meditation, yoga, journaling, deep-breathing exercises, and walking.
Sleep deprivation can also exacerbate insulin resistance and, effectively, obesity.  To ease PCOS weight gain as a result of high blood sugar, adults should ensure that they sleep seven to nine hours every night. That said, pre-teens should be getting nine to 12 hours of sleep every night, while teens should aim to sleep for six to 10 hours nightly. 
Polycystic ovary syndrome is a predominantly hormonal condition that is commonly seen in individuals who are premenstrual or menstruating. Those with this condition often experience symptoms related to insulin resistance and hyperandrogenism, which can include infertility, acne, abnormal menstruation patterns, and weight gain.
While there is no cure for PCOS, girls, women, and people AFAB can manage PCOS-related weight gain by making several lifestyle changes related to diet, exercise, sleep, and stress management. You can also speak to a healthcare provider about starting a medication that can address insulin resistance or infertility.
At Everlywell, we provide women’s online health services. The program includes virtual visits with a licensed clinician, GLP-1 medication, and quarterly at-home lab tests to monitor your health status. We also provide an at-home Women’s Fertility Test if you believe PCOS is affecting your ability to conceive.
Enroll and explore our offerings today to empower your health.
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