Women's Health

A Guide to PCOS: Why does PCOS cause weight gain?

June 24, 2023
Fertifa Clinical Team

People living with polycystic ovary syndrome (PCOS) can experience body weight changes which can impact their healthy living habits, healthy diets, levels of insulin and other hormones, and more.

What is PCOS and how does it relate to weight gain?

A common condition relating to hormone levels, polycystic ovary syndrome (PCOS) affects females of reproductive age. It is characterised by a combination of symptoms, including irregular or absent menstrual periods, excessive levels of androgens (male hormones) in the body, and the presence of small cysts on the ovaries. Some people with PCOS may experience excess weight gain, which can be relating to hormone imbalance, medications, and other aspects of PCOS.

Not all people with PCOS will experience weight gain, and the extent of weight gain can vary. Lifestyle factors, such as diet and physical activity, can also influence weight management in PCOS. Managing PCOS-related extra weight often involves a combination of dietary changes, regular exercise, and, in some cases, medication to address specific symptoms like insulin resistance. We recommend consulting with a healthcare professional, such as an endocrinologist or gyneacologist, as they can provide personalised guidance and treatment options for PCOS and its associated weight concerns.

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Hormonal imbalance

One of the most common symptoms associated with PCOS is excess body weight or difficulty in losing weight. The relationship between PCOS and weight gain is complex, but for many people, abnormal hormone levels play a large role. Some individuals find that hormone therapy can help manage factors for weight gain.

Insulin Resistance

Insulin is a hormone that helps regulate blood sugar levels. In PCOS, the body's cells become less responsive to insulin, leading to a risk of insulin resistance. This causes the pancreas to produce extra insulin to compensate. Elevated insulin levels can contribute to weight gain by increasing hunger, promoting fat storage, and inhibiting the breakdown of stored fat.

Elevated Androgen Levels

People with PCOS often have higher levels of hormone androgens (male hormones) such as testosterone. These elevated androgen levels can contribute to weight gain by increasing appetite, especially for high-calorie foods, and promoting abdominal fat deposition.

Other Hormone Changes

  1. Disrupted ovarian function: In PCOS, the ovaries may not regularly release eggs (ovulation), leading to an imbalance in reproductive hormones. This imbalance includes higher levels of estrogen (female hormones) and lower levels of progesterone. Elevated estrogen levels (sometimes written 'oestrogen') can promote weight gain by increasing appetite and promoting fat storage, especially around the hips and thighs.
  2. Low thyroid function: Some individuals with PCOS may also have an under-active thyroid (hypothyroidism) or suboptimal thyroid function. The thyroid gland produces hormones that regulate metabolism. When thyroid function is impaired, it can slow down metabolic rate and contribute to weight gain.
  3. Inflammation: PCOS is associated with chronic low-grade inflammation in the body. Inflammatory markers can disrupt normal hormonal regulation, including insulin sensitivity, and contribute to weight gain.

Complications from PCOS and weight gain

Increased Risk of Heart Disease and Diabetes

  1. Increased risk of type 2 diabetes: Insulin resistance, commonly seen in PCOS, can progress to type 2 diabetes. Excess weight gain can further exacerbate insulin resistance and increase the risk of developing diabetes.
  2. Cardiovascular disease: PCOS and weight gain are associated with an increased risk of developing cardiovascular problems, including high blood pressure, high cholesterol levels, and heart disease. These risks are attributed to factors such as insulin resistance, dyslipidemia, and inflammation.

Fertility Issues

PCOS is a leading cause of infertility in females. Weight gain can further affect fertility by disrupting hormone levels and a women's menstrual cycle. Additionally, overweight or obese people with PCOS are at an increased risk of complications during pregnancy, such as gestational diabetes, preeclampsia, and premature birth.

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Obstructive Sleep Apnoea

Obesity and excess weight gain can increase the risk of developing sleep apnoea, a condition where breathing is interrupted during sleep. Sleep apnoea and lack of sleep can lead to daytime fatigue, poor sleep quality, and other health complications. People who get insufficient sleep can also be affected by changes in mood, diet, and behavior. We recommend trying to prioritize getting adequate sleep, 7 hours of sleep or more, each night to avoid symptoms getting worse.

Increased Risk of Endometrial Cancer

Some studies suggest that individuals with PCOS may have a higher risk of developing endometrial (uterine) cancer due to prolonged exposure to estrogen without regular shedding of the uterine lining. Excess weight gain can further increase this risk.

Additional Impacts and Risk Factors

  1. Psychological and emotional impact: Weight gain can contribute to low self-esteem, body image issues, and psychological distress in people with PCOS. The hormonal imbalances associated with PCOS can also contribute to mood swings, depression, and anxiety.
  2. Joint and musculoskeletal issues: Carrying excess weight puts additional strain on the joints, leading to joint pain and an increased risk of conditions like osteoarthritis. Weight gain can also impair mobility and make physical activity more challenging.

Common symptoms of PCOS-related weight gain

When weight gain is associated with polycystic ovary syndrome (PCOS), there are several common symptoms that may accompany it. These symptoms can vary among individuals and may not always be present in people with weight gain related to PCOS. We recommend consulting your healthcare provider if you have any concerns relating to PCOS and weight gain.

Abnormal Periods or Irregular Bleeding Patterns

Irregular periods can affect a percent of females experiencing PCOS as a result form changes in hormone levels, medications, and other factors. Weight gain alongside irregular menstrual periods is not uncommon for individuals with PCOS and we recommend speaking with your provider if you think you are experiencing these symptoms.

Acne Breakouts, Excessive Hair Growth, or Hair Loss

Higher androgen levels can lead to acne breakouts, excess body hair growth and facial hair, or hair loss. If experiencing excess hair growth or any of these symptoms and have noticed fluctuations or recent changes in your weight, it is possible that it can be related to PCOS. Always chat with your healthcare provider before assuming any diagnosis

Bloating or Swelling in the Abdomen Area

Weight gain related to PCOS is often triggered by high androgen levels (male hormones) and as a result weight gain is typically concentrated in the abdomen. This pattern of weight gain is associated with increased health risks compared to weight gain in other areas of the body.

Additional Symptoms

1. Difficulty losing weight: People with PCOS often struggle to lose weight or experience challenges in maintaining a healthy weight. This difficulty may be due to hormonal imbalances, insulin resistance, and metabolic abnormalities associated with PCOS.

2. Rapid weight gain: Some people with PCOS may experience rapid or sudden weight gain, which can be distressing and difficult to manage. This can be attributed to factors such as hormonal fluctuations and changes in metabolism.

3. Insatiable hunger, emotional eating, or food cravings: PCOS-related weight gain can be accompanied by an increased appetite, frequent cravings (especially of sugary foods), or difficulty controlling food intake. These symptoms may be related to insulin resistance, imbalances in hunger-regulating hormones, and psychological factors. Creating diet modifications may help manage food cravings and control weight gain in individuals.

4. Difficulty in maintaining muscle mass: Weight gain associated with PCOS may involve a higher proportion of fat accumulation compared to muscle. This can lead to a decrease in overall muscle mass, affecting body composition and metabolism.

5. Swings in weight: Some people with PCOS may experience fluctuations in weight, with periods of weight gain followed by weight loss or vice versa. These fluctuations can be attributed to various factors, including changes in hormonal levels and insulin sensitivity.

Not all people diagnosed with polycystic ovary syndrome (PCOS) will experience weight gain depending on each medical condition. Each individual case is unique and different treatment options will work for different people. Gaining weight can be stressful and difficult. Remember to be kind to yourself during the process and express any concerns and make goals with your healthcare provider on your individual treatments 💜

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