Why it can be hard to lose weight with PCOS

What is insulin resistance, and what health implications does this have?

PCOS is a metabolic condition as well as a reproductive syndrome—our hormones influence both systems. 70% of people with PCOS develop some form of insulin resistance.

Insulin is a hormone secreted by our pancreas whose job is to convert glucose, or blood sugar, into energy for our muscles to use. If we are insulin resistant, our body does not do this conversion as efficiently as other bodies. This means that our pancreas must produce higher amounts of insulin relative to our blood glucose. Over time, this can exhaust our pancreas and lead to chronically-high blood sugar, which in turn can lead to prediabetes, diabetes, and weight instability.

Signs of weight instability and insulin issues

A major sign that our metabolic system and its associated hormones have changed is large fluctuations in body mass. Insulin resistance can be tricky; it can manifest without notable outward signs. Some potential minor symptoms include:

  • Accumulation of fat around the abdomen and digestive organs can occur due to the body cells’ inability to use sugar in the bloodstream.
  • Elevated blood sugar—hyperglycemia, which can lead to excessive thirst, frequent urination, fatigue, and other symptoms.
  • Dark patches of skin (Acanthosis nigricans) or skin tags, often found in body folds around the groin, neck, or under the arms, can develop from rapidly reproducing skin cells. Insulin is an integral player in skin and hair growth, therefore unregulated insulin can be revealed through these skin irregularities.
  • Large pores and acne can develop as a result of a high fat and high carbohydrate diet associated with increased sebum production and insulin resistance.
  • Hair loss and female pattern baldness can develop due to insulin’s integral role in hair growth.
  • Swollen ankles or other swollen parts of your body can be a sign of insulin resistance. Insulin acts in cooperation with the kidneys to regulate water and sodium storage. When insulin is dysregulated, fluid can be held in the body unnecessarily.
  • Insatiable hunger can be a sign of imbalances in insulin levels. With insulin resistance, the body is unable to absorb sugar from the bloodstream into body cells, so the cells signal hunger and starvation to the brain.
  • Tingling Sensations in hands or feet (Paresthesias) can be felt when there is insulin resistance so severe that nerve damage has begun to create peripheral nerve pain.

The hormonal explanation behind this, as explained, lays in an unresponsiveness to insulin. Over time, this leads to sugar buildup in the bloodstream. Over time a sugar buildup can be absorbed by fat cells.

When it comes to weight instability, another key factor is the high androgen concentrations associated with PCOS. High androgens can lead to symptoms such as weight gain around the abdomen.

And unfortunately, a viscous cycle occurs between high androgens and insulin resistance: high androgens can worsen insulin resistance. For this reason, treating PCOS as a whole-body condition is very important.

Treatment options for weight gain and insulin resistance

There are a variety of lifestyle and pharmaceutical-based treatment strategies for managing PCOS weight gain and insulin resistance.

  • Diet
  • High-fiber, low-sugar diets can help regulate blood sugar levels — your Pollie care team and health coach can help you find healthy eating habits that can become a sustainable long-term change!
  • Exercise
  • Exercise has also been shown to aid in improving insulin sensitivity. Short, high intensity exercise may be a good option for you if insulin resistance is a part of your PCOS journey. More gentle forms of exercise such as yoga and walking have also been shown to help.
  • Hormonal Therapy
  • Supplementing hormones, such as estrogen, progesterone, or thyroid hormone can help counteract hormonal imbalances with androgens. Before beginning hormonal treatments, it is important to confirm with laboratory tests and your healthcare provider.
  • Metformin (Glucophage) and other prescription drugs
  • Pharmaceuticals like metformin can help regulate blood sugar levels and prevent or treat type II diabetes.
  • Insulin-Lowering Supplements
  • Myo and d-Chiro-inositol in a 40:1 ratio has been found to balance both metabolic and reproductive facets of PCOS, including improvements to insulin, androgens, and weight.

Where to learn more

Curious about learning more about insulin resistance and weight gain with PCOS? Check out our PCOS Program where you can learn how to take control of your PCOS with Pollie's hormonal health specialists, advanced labs, curated educational materials, and personalized care pathways.