That’s a good question!
Weight gain or inability to lose weight is a common symptom of PCOS, and the one symptom that seems to be the most frustrating for many women. In my opinion, weight is given an unhealthy amount of attention! The common advice from medical providers upon diagnosis of PCOS is “lose weight”. This advice often sends women spiraling into a world of dieting, restriction, disordering eating, and over-exercising. The part that’s most frustrating is pursuing weight loss by any means possible almost always fails! And then we end up frustrated, worried, and angry.
I find that most women don’t understand WHY they have trouble losing weight and so easily gaining weight, in the first place. When we understand WHY this is happening, we can better understand that it’s the real root causes that need to be addressed, not the weight itself.
Let’s take a closer look!
Is insulin resistance to blame?
Most women with PCOS have insulin resistance. Insulin is the hormone that helps to use and distribute glucose (sugar) within the cells. When you have insulin resistance, this means that insulin is not able to use glucose well. The body wants the glucose, but isn’t able to use it since insulin is resistant. The body asks for more sugar (hello, cravings!) and insulin levels stay high. You may respond to cravings with more glucose, which in turn increase insulin levels. Insulin is a growth hormone, and when left untreated can cause growth, aka weight gain. Insulin resistance left untreated makes it nearly impossible to lose weight and easy to gain.
Is hormone imbalance causing weight gain?
Many women with PCOS have high testosterone levels, among other androgens. Testosterone is a growth hormone. You may find that it’s easier for you to build muscle. Testosterone is the hormone to thank for that! This ability to build muscle can result in a higher weight.
Leptin, the satiety hormone, signals to your body that it’s full. Often, women with PCOS have low levels of leptin which often leads to hunger. Of course, when we are hungry we want to eat, which increases calorie consumption.
Could it be chronic dieting?
Dieting predicts weight gain and worsens PCOS. Yet, “weight loss” is often the first advice PCOS cysters receive and dieting is often used to try to achieve this. Our cells want to be fed and will let you know it. If you are depriving your body of needed fuel, it will respond by turning off certain systems (goodbye, period!). Dieting increases cravings, food obsession, inflammation, and eventually you’ll give in; not because you have no willpower but you body’s physiology is telling you it’s time to eat. This puts you in a restrict-binge cycle which can lead to further weight gain and doesn’t address insulin resistance or hormone imbalance.
What else could it be?
Poor mental health (depression and anxiety), emotional eating, poor sleep (contributes to cravings, fatigue, insulin levels), high stress (high cortisol, more cravings, high insulin, less sleep), a sedentary lifestyle, and poor nutrition can also lead to weight gain or weight cycling.
You can see now that weight gain with PCOS is NOT YOUR FAULT! It’s not necessarily something we can control. Humans come in all shapes and sizes, and I think we should celebrate that, not try to change it. However, we also each have a set-point weight. This is the weight you’re at when you’re caring for your body through nutrition, exercise, and lifestyle without excessive restriction, pain, stress, or effort. It’s true that you may feel better than you do right now at a different weight—that’s okay. But instead of just pursuing weight loss, allow your body to change as it needs, while doing the things you can do to care for it! This may mean looking further into addressing the root causes of your PCOS, evaluating what’s important to you in your life, and choosing habits you can implement long-term without it taking over your entire life!
Wondering why you’re gaining weight and ready to move forward with addressing the root cause?
Learn more about my 1:1 PCOS Nutrition Coaching Program here!