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Weight loss improves polycystic ovary symptoms. But do not wait until middle age – start now

Women with polycystic ovary syndrome (PCOS) are more likely to be overweight or obese and their symptoms worsen the heavier they are.

What causes this weight gain? How to lose weight help? And how can women lose those extra pounds to improve what they describe as distressing symptoms?

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Explanation: what is polycystic ovary syndrome?

PCOS is the most common hormonal disease in women of childbearing age. Symptoms include irregular periods, or signs of high levels of male hormones, such as excessive hair growth or severe acne.

Women find it distressing to deal with these symptoms when they feel their female identity is challenged. They also report the lack of support from health professionals and colleagues, and are worried about long-term risks, such as the development of type 2 diabetes.

Women with PCOS are two to three times more likely to be overweight or obese (with a body mass index of 25 kg / m² or more) compared to women without this condition. And they gain more weight per year (over 260g) than women without PCOS of the same age. Many women with PCOS also have difficulty losing weight or keeping it off.

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Does weight gain worsen PCOS symptoms?

Heavier women with PCOS tend to have worse symptoms. The question is whether gaining weight worsens symptoms or whether PCOS itself causes women to gain weight.

To prove that weight gain aggravates the symptoms of PCOS, we need studies in which women are asked to gain weight and their symptoms monitored for change. We doubt that such study has been done for ethical issues related to potential harm to participants. Not to mention the challenges in recruiting women for a study where they would gain weight. Therefore, we need to look for other forms of evidence.

An observational study in Finland found that an increase in BMI in women aged 14-31 years was associated with a higher probability of irregular periods, excessive hair growth or diagnosis of PCOS.

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And when women with PCOS lost weight through lifestyle changes, such as eating less or increasing physical activity, a Cochrane review showed a reduction in male hormones and excessive hair growth.

Given the above evidence, we can conclude that weight gain is likely to aggravate PCOS symptoms.

Does PCOS cause weight gain or prevents you from losing weight?

Many women with PCOS say they find it very difficult to lose weight, but we do not fully understand why.

Women with PCOS have the same metabolic rates as women without PCOS. They eat a few more calories (about 200 kilojoules a day, or the equivalent of a cube of cheese) than women without PCOS. This could lead to an increase of 2-3 kg over a year.

Women with PCOS may have different levels of hormones that control appetite, and high levels of male hormones may increase desire for high-fat foods.

But when provided with similar levels of support, women with and without PCOS lose the same amount of weight.

When given with similar levels of support, women with and without PCOS lose the same amount of weight.

Looking beyond PCOS, all women of childbearing age appear to have small, but persistent, amounts of weight. Women, on average, earn up to 600g per year from the age of 18. Married or partnered women who start working or have children are more likely to gain weight.

The reasons why women gain weight may be related to the challenges of maintaining a healthy lifestyle due to lack of time, energy, motivation and support for family and friends.

These reasons tend to be similar for women with and without PCOS. However, women with PCOS may face additional challenges as they describe ongoing stress living with symptoms of PCOS such as unpredictable periods.

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Women with PCOS also have higher levels of anxiety and depression and lower quality of life, which can compromise their ability to adopt a healthy lifestyle.

Recent focus groups that we conducted revealed that women with PCOS reported "a lifetime of yo-yo diets" with repeated cycles of weight loss followed by weight regain. Often these cycles result in a total weight gain over the years.

What should I do if I have PCOS?

Instead of following unsustainable diets, which could lead to a weight cycle and a sense of defeat, aim for small (and therefore sustainable) changes in diet and exercise.

Find something you like. Set yourself the all-encompassing goal to maintain your weight and improve your health, whatever it is now.

Keeping track of your weight by weighing yourself regularly (say, once a week) can help. If you have regular medical appointments, having your doctor monitor your weight changes between visits can also help you maintain your weight.

If you are 25 now, simply maintaining your current weight would be tantamount to losing more than 20 kg permanently when you are 50 years old. We know that this is almost impossible. Maintaining the same weight is a much more viable and equally beneficial goal.

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