You've tried every diet. You eat "right," you exercise, you count your calories. And yet, the weight doesn't budge. Or worse, it keeps increasing. You feel guilty, as if it's your fault, as if you're not trying hard enough. But the problem isn't you. The problem is that with PCOS, your body doesn't function like that of a woman without a hormonal disorder.
Traditional diets don't work because they don't address the root causes of weight gain, such as insulin resistance, excess androgens, chronic inflammation, and metabolic imbalances. This article breaks down why losing weight with PCOS is so difficult, debunks common misconceptions that make you feel guilty, and provides concrete, scientifically validated strategies for sustainable weight loss.
What you will discover
- Why is it so difficult? : precise mechanisms of insulin resistance, hyperandrogenism, inflammation and slowed metabolism
- Why traditional diets fail calorie restriction, yo-yo effect, eating disorders
- Approaches that work Glycemic load controlled diet, low-carb diet, intermittent fasting, chrononutrition
- Adapted sports program Weight training > cardio, HIIT, and why exercise alone is not enough
- Real testimonies Women who have lost 10-25kg using detailed protocols
- Managing frustration : moving away from diet culture and weight stigma
Weight Gain in PCOS: It's Not Your Fault
Let's start by being clear. If you have PCOS and are overweight, it's not because you lack willpower. It's not because you're not trying hard enough. It's because your metabolism is disrupted by hormonal mechanisms over which you have no direct control.
Figures
Between 40 and 80% of women with PCOS are overweight or obese. Being overweight worsens PCOS symptoms (a vicious cycle), but PCOS also promotes weight gain (a vicious cycle in the opposite direction).
A 2020 study compared overweight women with PCOS to women of normal weight with PCOS. Conclusion: no difference in hormonal markers (LH/FSH, testosterone, prolactin, TSH). Weight is not the cause of PCOS. PCOS is the cause of weight gain.
The 4 Mechanisms That Make Weight Loss Difficult
Understanding what is happening in your body allows you to move beyond guilt and target the right solutions.
1. Insulin resistance (Present in 70% of women with PCOS)
What is happening : Your cells are not responding well to insulin. As a result, your pancreas is producing much more to compensate. This hyperinsulinemia sends a constant message to your body: "Store, store, store."
Consequences :
- Preferential fat storage, especially in the abdominal area
- Blocking lipolysis (the ability to burn fat)
- Uncontrollable sugar cravings
- Chronic fatigue after meals
Why a traditional diet doesn't work: Reducing calories without managing insulin is pointless. Your body still stores fat, and you're hungry all the time.
2. Hyperandrogenism (Excess of Male Hormones)
What is happening : Your ovaries are producing too much androgen (testosterone). Hyperinsulinemia stimulates this production. Androgens promote the accumulation of abdominal fat (an android body type, as seen in men).
Consequences :
- Visceral fat (around the organs) is more abundant
- Reduced muscle mass (excess androgens have a paradoxical effect in women)
- Slowed basal metabolism
The paradox: You have too many androgens, but your body isn't using them to build muscle like a man. They're just promoting fat storage.
3. Low-Grade Chronic Inflammation
What is happening : Inflammatory markers (CRP, IL-6, TNF-alpha) are elevated in women with PCOS, even those who are not overweight. This inflammation disrupts satiety signals and promotes insulin resistance.
Consequences :
- Leptin resistance (the satiety hormone): you never feel full.
- Worsening of insulin resistance
- Water retention and a feeling of constant swelling
The vicious cycle: Being overweight worsens inflammation, which worsens insulin resistance, which promotes weight gain.
4. Slowed Metabolism
What is happening : Your resting energy expenditure is lower than that of a woman without PCOS. You burn fewer calories, even at rest.
Why : Reduced muscle mass + frequent subclinical hypothyroidism + mitochondrial dysfunction (your cells produce less energy).
The problem : You have to eat very little to lose weight. And as soon as you start eating "normally" again, you gain it all back (yo-yo effect).
❓ Better Understanding PCOS (Symptoms, Pain & Treatments) →
Why Traditional Diets Don't Work
You've tried Weight Watchers, the 1200-calorie diet, strict calorie restriction. The result: you may have lost 2-3 kg, then completely plateaued. Or worse, regained the weight. Why?
Reason 1: Calorie Restriction Alone Does Not Target Insulin
Eating 1200 calories of cereal, fruit, and low-fat yogurt won't change your insulin resistance. You'll still experience blood sugar spikes, your pancreas will continue to produce too much insulin, and you'll store fat. Plus, you'll be hungry all the time, so you'll give in to cravings.
Reason 2: Your Body Adapts and Slows Down Even More
When you eat too little for a long time, your body thinks it's starving. It slows down its metabolism to conserve energy. You burn even fewer calories than before.
Result: At first, you lose weight. Then you plateau. Then you have to eat even less to continue losing. It's unsustainable, you end up cracking, and you gain it all back plus more (yo-yo effect).
Reason 3: Risk of Eating Disorders
Restrictive diets promote eating disorders (EDs): restriction/compulsion, binge eating, orthorexia. Women with PCOS are already at higher risk of developing EDs (11% vs. 5% in the general population).
Guilt, obsession with food, loss of control: these diets damage your relationship with food in the long term.
Reason 4: "Light" and "0%" products are traps
Fat-free yogurts, diet sodas, and "slimming" protein bars: they're packed with sweeteners, additives, and often hidden sugars. They perpetuate your addiction to sweet tastes and don't teach you how to eat healthily.
Strategies That Actually Work
Now that we understand what doesn't work, let's look at what does. All these approaches target insulin resistance and inflammation, not just calories.
Strategy 1: Glycemic Load Controlled Diet
This is the basic principle. Not a diet, but a way of eating. You prioritize foods with a low glycemic load (GL), which don't cause your insulin to spike.
Principles :
- Whole grains only (brown rice, quinoa, oats, wholemeal bread)
- Legumes at almost every meal (lentils, chickpeas, beans)
- Protein at every meal (meat, fish, eggs, tofu)
- Good fats (avocado, nuts, olive oil, oily fish)
- Unlimited vegetables
- Fruit in moderation (2 portions/day max, always with protein/fat)
Expected results : Improved insulin sensitivity within 2-3 months. Moderate but sustainable weight loss (2-4 kg per month). Reduced cravings.
Strategy 2: Low-Carb (Carbohydrate Reduction)
More radical than strategy 1, but very effective for many women with PCOS. You drastically reduce carbohydrates (less than 100g per day) and increase protein and fat intake.
How to do :
- Eliminate: bread, pasta, rice, cereals, potatoes, sugar
- Keep: green vegetables, animal protein, eggs, cheese, avocado, olive oil, nuts
- Limit fruit (1 portion/day max)
Why it works: Fewer carbohydrates = less insulin = fat burning. Your body switches into "fat-burning" mode (mild ketosis).
results: Rapid weight loss in the first few weeks (3-5 kg), then 2-3 kg/month. Rapid improvement in insulin resistance.
Please note: Not suitable for everyone. Some women experience fatigue or irritability. It should be tested for 3 months, with medical supervision if possible.
Strategy 3: Intermittent Fasting
You concentrate your meals into an 8-hour window (e.g., 12pm-20pm), and you fast for 16 hours. During the fast, you drink water, tea, and coffee without sugar.
Why it works: During fasting, your insulin levels drop, and your body burns stored fat. Fasting dramatically improves insulin sensitivity.
Protocol 16/8:
- Last meal at 20pm
- Fasting from 20 p.m. to 12 p.m. the following day
- First meal at 12pm, last at 20pm
- 2 or 3 meals within the 8am window
results: Weight loss: 2-4 kg per month. Significant reduction in waist circumference. tailleImproved energy and mental clarity.
Please note: Contraindicated if you have a history of eating disorders, are trying to get pregnant, or have very irregular periods (may worsen symptoms). Test gradually.
Strategy 4: Chrononutrition
Eating at the right time of day. Studies show that women with PCOS who consume more calories at breakfast and fewer at dinner lose more weight and improve their insulin sensitivity more.
Principle :
- A hearty breakfast rich in protein (30-35% of daily calories)
- Average lunch (30-35%)
- Light dinner (25-30%)
- No snacking in the evening
Results of a study: PCOS women who followed this regimen had a 50% reduction in fasting insulin and a 30% improvement in testosterone, compared to those who ate more in the evening.
🍽️ Sample 7-Day Meal Plan & Complete Food List for PCOS →
Sport & PCOS: What Works
Physical activity is essential, but not just any kind. Running for an hour every day won't make you lose weight if you don't change your diet. However, the right type of exercise will amplify the results.
Weight training > Cardio
Weight training is the most effective exercise for improving insulin resistance. Why? Because it increases your muscle mass, and muscles use glucose. The more muscle you have, the better your body processes sugar.
Recommended program:
- 3 weight training sessions per week (45 min)
- Work all muscle groups (squats, push-ups, deadlifts, lunges, presses)
- Progressive loads (free weights or machines)
- Recovery: 48 hours between two sessions of the same muscle group
results: Improved insulin sensitivity within 4-6 weeks. Increased basal metabolic rate. Fat loss (even if the weight on the scale doesn't change immediately, because you're gaining muscle).
HIIT (High-Intensity Interval Training)
Short, intense bursts of effort followed by recovery. Highly effective for burning fat and improving insulin resistance in a short time.
Example of a HIIT session (20 min):
- 3-minute warm-up
- 8 cycles of: 30 seconds of intense effort (sprints, burpees, jumping jacks) + 30 seconds of active recovery
- Return to calm in 3 minutes
- 2-3 times/week maximum (very demanding)
🤰 Protocols & Testimonials Getting Pregnant with PCOS →
Moderate Cardio: Useful But Not Enough
Brisk walking, cycling, and swimming are excellent for cardiovascular health and stress management. However, they are not enough to lose weight with PCOS. They should be combined with strength training.
frequency: 30 minutes of brisk walking or equivalent per day. More if you like, but don't replace strength training with cardio.
Testimonials: They Lost Weight with PCOS
Real stories, with concrete protocols.
Camille, 31 years old – Lost 12 kg in 6 months
"I weighed 82 kg at 1.68 m tall. I followed a strict low-carb diet for 3 months, then I reintroduced low-GI carbohydrates. I started weight training 3 times a week. The first 3 months: -8 kg. The next 3: -4 kg. My cycles regulated, my acne disappeared, I no longer have cravings. I now weigh 70 kg and I feel so much better."
Protocol: Low-carb (80g carbs/day) + weight training 3x/week + 30 min walk/day + myo-inositol
Julie, 28 years old – Lost 18 kg in 10 months
"I started at 92 kg. I did a 16/8 intermittent fast, with a Mediterranean diet (lots of vegetables, fish, legumes). Weight training twice a week + HIIT once a week. The first 5 months: -10 kg. The next 5: -8 kg. I went from 92 to 74 kg. I got my period back after 2 years of amenorrhea."
Protocol: Intermittent fasting (16/8) + Mediterranean diet + weight training twice a week + HIIT once a week + metformin (prescribed by her doctor)
Sophie, 35 years old – Weight loss of 25 kg in 18 months
"I weighed 105 kg at 1.70 m tall. For 10 years, I yo-yoed. I finally understood that I had to manage my insulin resistance. I consulted a dietician specializing in PCOS. Low GI diet, chrononutrition (large breakfast, light dinner). Weight training 3 times a week + daily walks. It took time, but I lost 25 kg and I haven't gained it back. I weigh 80 kg and I feel incredibly better."
Protocol: Low GI + chrononutrition + weight training 3x/week + 10,000 steps/day + dietitian follow-up + psychological support
Managing Frustration and Overcoming Guilt
Losing weight with PCOS is a long process. It's frustrating. Results take time to appear. And society doesn't help with its "eat less, move more" message.
Rejecting the Weight Stigma
Weight stigma is discrimination based on weight. You've probably experienced it: comments from loved ones, judgments from doctors ("you just need to go on a diet"), stares in the street. This stigmatization worsens stress, which worsens cortisol levels, which worsens insulin resistance.
What you need to know : Your weight isn't a matter of willpower. You're not lazy. You have a metabolic disorder that objectively makes weight loss more difficult. Don't blame yourself.
Get Accompanied
Going it alone is tough. Support makes all the difference.
- Dietitian specializing in PCOS She will tailor the diet to your specific case; there is no generic protocol.
- Psychologist If you have a complicated relationship with food, eating disorders, or an enormous mental load
- Sports coach To learn the correct weight training movements and stay motivated
- PCOS Women's Communities Forums, Facebook groups, associations (Asso'SOPK). Sharing with women who are going through the same thing is a relief.
Set Realistic Goals
Forget about losing 10 kg in one month. With PCOS, sustainable weight loss is 2-4 kg per month. It seems slow, but over 6 months, that's 12-24 kg. And most importantly, you won't gain it back.
Weight-free goals to celebrate
- Return of ovulation and more regular cycles
- Acne improvement
- More energy, less fatigue
- Disappearance of cravings
- Improved sleep
- Better self-esteem
Your body isn't broken, it's just different.
Losing weight with PCOS is objectively more difficult due to insulin resistance, excess androgens, chronic inflammation, and a slowed metabolism. Conventional diets don't work because they don't target these mechanisms.
The approaches that work include glycemic-load controlled diets, low-carb diets, intermittent fasting, and chrononutrition. Combined with strength training (3 times per week), these strategies improve insulin resistance and unlock weight loss.
Losing just 5-10% of your initial weight is enough to significantly improve your symptoms. Aim for 2-4 kg per month. It's slow, but sustainable. And above all, don't feel guilty: it's not your fault.
Sources & References
- Moran LJ, et al. (2013). Dietary composition in the treatment of polycystic ovary syndrome: a systematic review to inform evidence-based guidelines. J Acad Nutr Diet. DOI: 10.1016/j.jand.2013.05.027
- Marsh KA, et al. (2010). Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. DOI: 10.3945/ajcn.2010.29261
- Paoli A, et al. (2020). Effects of a ketogenic diet in overweight women with polycystic ovary syndrome. J Transl Med. DOI: 10.1186/s12967-020-02277-0
- Barber TM, et al. (2019). Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies. Clin Med Insights Reprod Health. DOI: 10.1177 / 1179558119874042
- Almenning I, et al. (2015). Effects of high intensity interval training and strength training on metabolic, cardiovascular and hormonal outcomes in women with polycystic ovary syndrome. PLoS One. DOI: 10.1371/journal.pone.0138793
Disclaimer This article is for informational purposes only and does not replace medical advice. For personalized weight management with PCOS, consult a doctor, endocrinologist, or registered dietitian.
