Most conversations with your doctor about polycystic ovary syndrome (PCOS) probably tend to focus on irregular menstrual periods, including missed and/or heavy periods. But people with PCOS face other issues, too — and a big one is weight gain.
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It’s not clear whether PCOS is a direct cause of the extra pounds many people with PCOS carry, but according to Ob/Gyn Yolanda Thigpen, MD, a link does exist.
“Experts think a combination of genetic predisposition and environmental factors, including diet, exercise and lifestyle, contribute to the PCOS symptoms,” she says.
PCOS affects up to 15% of women and people assigned female at birth (AFAB), with symptoms appearing as early as age 11.
Knowing how it can impact your weight can help motivate you to take control of it and other health issues, including diabetes, she says.
Dr. Thigpen explains what PCOS weight gain looks like and how you can minimize the impact of PCOS on your life.
PCOS occurs when your hormones are out of balance. Women and people AFAB with PCOS make slightly more male hormone called androgen than normal. Even a tiny increase in androgen production can have an impact on how your ovaries function.
Healthcare providers look for two out of three symptoms when making a diagnosis:
PCOS can also cause:
But the symptom that’s most likely connected to weight gain is insulin resistance, Dr. Thigpen states.
Many people who have PCOS also have insulin resistance, which happens when your body has difficulty pulling glucose from your bloodstream and converting it to energy. So, your body needs to produce more insulin in an attempt to maintain a normal blood sugar level. Over time, your body begins to overproduce insulin to keep your blood sugar level normal.
Insulin resistance is often cited as a large contributing factor to obesity, Dr. Thigpen says. When blood glucose levels continue to rise despite increased insulin levels, Type 2 diabetes develops.
“PCOS itself might make a person gain weight more easily than others,” she adds. “And the more weight they gain, the more additional symptoms they’ll have.”
In fact, she says that more than half of people with PCOS have overweight.
While most women or people AFAB tend to carry weight in their hips, thighs and buttocks — which is known as a pear-shaped body — people with PCOS tend to carry their weight in their abdomen. This resembles an apple shape.
“A PCOS belly is characterized by excess weight gain around the midsection, which can be difficult to lose,” clarifies Dr. Thigpen. “This type of weight gain is often referred to as central obesity.”
You may have heard of the term “PCOS belly.” This is the area where fat resides in your lower abdomen. It can appear as if you’re bloated.
“The waist-to-hip ratio is greater due to fat accumulation and is often described as having a ‘spare tire’ or ‘muffin top’ appearance,” explains Dr. Thigpen.
Unfortunately, there’s no cure for PCOS. But there are things you and your doctor may do to minimize its impact:
Whether PCOS is a direct cause of weight gain or not, it’s clear that losing weight is helpful, Dr. Thigpen says. “When it comes to PCOS, a main focus is always on weight loss, diet modification and lifestyle changes.”