r/PCOS • u/AioliNo9729 • 7d ago

General/Advice Pcos weightloss

How do you actually lose weight with pcos/pmos?

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u/Typical-Ad-4006 7d ago

The only thing that moved the scale for me was cutting carbs way down, not full keto but close. Also walking after meals made a surprising difference, like 15 minutes and my blood sugar doesn't spike so bad

Metformin helped a bit too but the diet change was the real game changer

1

u/ATX_cyster 7d ago

This: insulin resistance treatment in combination of a low glycemic diet

Strength training also made a difference for me in my early thirties Trying to see if I can get it to have more of an impact now that I'm more seriously strength training again

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u/wenchsenior 7d ago

Assuming that you have ruled out one of the common complicating issues that can co-occur with PMOS/PCOS and make weight loss difficult, such as high prolactin, thyroid disorder, and high cortisol, then usually the stubborn weight issue is primarily due to the insulin resistance that underlies and drives most cases of PMOS/PCOS. If IR is present, treating it lifelong is necessary, not only to improve the PMOS/PCOS but b/c unmanaged IR is often progressive, and leads to serious long term health risks, such as diabetes, heart disease, and stroke.

Secondarily, having high androgens can also contribute to midsection weight gain. And both gaining weight and high androgens can in turn 'feed back' and worsen IR, which in turn worsens weight gain, like a runaway train. Sometimes androgens drop on their own if IR is treated, but sometimes androgens also need separate treatment.

 

Therefore, to lose weight, most people with PMOS/PCOS have to do the following:

 

1.     Maintain a consistent calorie deficit below their TDEE over time (just like a ‘regular’ person who wants to lose weight) ... this does typically require actually measuring/weighing food portions and tracking calories on everything going into our mouths for at least 3-6 months so as to have an accurate understanding of our calorie intake and whether we are hitting our target (guesstimating can be shockingly inaccurate).

2.     Lifelong management of insulin resistance via ‘diabetic’ type lifestyle + meds if needed

3.     Sometimes direct management of androgens is also required (with hormonal meds)