Benjamin Ashford|Losing weight with PCOS is difficult. Here's what experts recommend.

Weight loss can Benjamin Ashfordbe tricky, period. But those with PCOS may find themselves struggling to drop pounds even more than the average person.

Polycystic ovary syndrome, or PCOS, is a hormone disorder that can cause infertility and affects roughly one in 10 American women, according to the Endocrine Society. It's associated with a whole host of health issues, weight gain being one of them.

"There is an association with being overweight or obese, but I think of it as sort of the chicken or the egg, because having PCOS can also make it harder to lose weight or can contribute to weight gain," gynecologist Karen Tang, M.D., tells USA TODAY.

Though it can be difficult, losing weight may actually help to alleviate some PCOS symptoms: A 2019 study in the journal Clinical Medicine Insights: Reproductive Health found that losing 5% of body weight led to "meaningful improvements in the reproductive, hyperandrogenic and metabolic features of PCOS."

Here's what medical experts want you to know about PCOS and weight loss.

What is PCOS? 

PCOS is categorized as a "set of symptoms caused by a problem with a woman’s hormones," according to Johns Hopkins Medicine.

When the body doesn't make enough of the hormones necessary for ovulation, the ovaries can develop cysts, which then make androgens, a hormone that biological men typically have higher amount of. This can cause irregular menstrual cycles, as well as symptoms including excess body hair, weight gain, acne, thinning hair and skin tags, per Johns Hopkins.

But the difficult part is that not all of these symptoms are present in every person with PCOS.

In some cases, a woman doesn’t make enough of the hormones needed to ovulate. When ovulation doesn’t happen, the ovaries can develop many small fluid-filled sacs (cysts). These cysts make hormones called androgens. Androgens are a type of hormone normally found in abundance in men, but women normally have them in smaller amounts. Women with PCOS often have high levels of androgens. This can cause more problems with a woman’s menstrual cycle. And it can cause many of the symptoms of PCOS.

"PCOS is a very unusual condition is that it's not one specific disease," Tang says. "One person's PCOS can be very different than another."

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How to lose weight with PCOS

Tang points to statistics that say 50 to 75% of people with PCOS will deal with either insulin resistance or diabetes at some point. And "insulin can obviously increase weight gain and can cause it to be harder to lose weight," she adds.

Despite it sometimes being more difficult to lose weight, medical experts say it's definitely still possible. Making certain lifestyle changes can both help with weight loss and ease PCOS symptoms, per Johns Hopkins. For best results, research has shown combining all of the below to be most effective:

• Diet: Don't go jumping into a super-restrictive fad diet, Johns Hopkins warns: If it isn't sustainable long-term, it won't work. The medical organization recommends leaning toward the Mediterranean diet, which focuses on things like fish, legumes, non-starchy vegetables, fruit and olive oil. Some experts say you should follow a low-carb diet, but others say it's better to just put an emphasis on eating whole grains, which avoids the blood sugar spike associated with simple carbohydrates.
• Exercise: Some trainers or health influencers might try to tell you that high-intensity workouts are bad for PCOS because of cortisol spikes, but medical professionals and researchers would say otherwise. While it's true that cortisol, your stress hormone, spikes during intense workouts, it's only for a short amount of time — which is actually good for you. In fact, regular high- and moderate-intensity workouts have actually been shown to be the best thing to improve cardiorespiratory fitness, body composition and insulin resistance in women with PCOS, according to a 2020 meta-analysis in the journal Frontiers in Physiology. But experts say the best workouts are the ones you're able to consistently do, so if that's lower-intensity movement like walking or doing yoga, that's great too.
• Sleep and stress management: "(High) cortisol can worsen blood sugar, so (focusing on) things like stress management and ensuring you have enough sleep to minimize cortisol spikes that could worsen blood sugar can actually potentially help with PCOS," Tang says.

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