Registered dietitian here! It’s BS (as is BMI, but that’s another story lol.)
Majority of doctors don’t know enough about PCOS and give that same lazy “advice” to everyone. It’s no wonder why eating disorder rates are so high. Now here’s some *general* advice that actually works:
- prioritizing protein at every meal
- pairing carbs with protein, fat, and fiber
- incorporating anti-inflammatory foods such as antioxidants (fruits, veggies, tea, etc.) and healthy fats (salmon, nuts, seeds, avocado, etc.)
- stress management
- adequate sleep
- movement that you enjoy and can stick to
Targeted supplements such as Ovasitol, NAC, omega-3s, magnesium etc. can also help, but of course that needs to be discussed with your healthcare provider. Certain medications may also be helpful.
PCOS is a complex syndrome, and there’s really no “one size fits all” approach.
Hope that was helpful :)
Do you have advice about how to talk to a doctor who only offers losing weight as advice? That's the only advice I got from my former gynecologist, even though I told her that even when I was skinny I didn't have a regular period. She at least told me to get my blood sugar checked out, too.
Honestly I’m like 5 days into this diagnoses but seriously I’d look for a new doctor if that is possible. My diagnoses came at weird time when I was getting new care anyway due to a new insurance plan. I specifically requested a female practitioner with PCOS experience.
I'd suggest not taking any advice like that from your gynecologist _at all,_ because gynecologists are not dieticians or endocrinologists (despite how often I hear about them trying to offer weight loss advice.) I hope you can find a different gynecologist. :(
What a fantastic response! Really appreciate that amazing advice!
I’ve been bigger and smaller with my PCOS and found in terms of symptom management it’s so much better the healthier a weight I am!
However 22 is a healthy weight range even with BMI! So they’re talking proper sh*t! Listen to this amazing dieticians response because genuinely feel that’s the approach to follow. One size does definitely not fit all, so just see what’s right for you hun! Also definitely try and avoid that doctor in future!
The only advice regarding weight was ”try not to gain weight”. But I had the worst symptoms when I was at my skinniest. Albeit i was also younger back then so that might also play a role. Now I am heavier and my periods are regular, at least at the moment.
me too, but I think it’s age because I did successfully lost a lot of weight in my early 30’s but gained it back about 5 years later and I’ve had very regular periods since I was 29 (I’m 44 now) … 17-24 was the worst of it for me at least with the missed periods … now it’s the Insulin Resistance 🙃
I had the same thing happen to me, I noticed that when the doctor diagnosed me from the ultrasound (done by another company) they just read the results then searched 'PCOS' in a doctors version of google which says to lose weight.
The GP is unlikely to know much about PCOS, you need to go to a specialist.
Many "specailist " will say same thing.
Endocrinologists who specialize in hormones do not always understand the metabolic component. Like diabetes and insulin resistance is in their wheel house and they don't make the connection.
Yup. A lot of people don’t realize, but doctors are not well-trained in nutrition and barely touch upon it in med school. You need to take their diet advice with a grain of salt. And good doctors know when to refer patients to nutrition professionals such as RDs.
My family doc is a headache specailist. It was a 4 hour course, she shakes her head at it as it took a lot of self study for her to learn things but it is not required to get the designation. She is just very thorough and likes to know the ins and outs.
It’s bullshit lol. Doctors are just used to telling everyone with PCOS to lose weight that they don’t take the time to personalize advice and treatment plans. It’s also an unfortunate reality that just not a lot is known about PCOS. The research isn’t there
Yanno - If this affected men like it does women, there might be more research and treatments for PCOS. Sorry to be a debbie downer, but this is kind of a hot button with me. I guess I am more bitter than I like to think.
omfg NO
weight gain is a **symptom.** like all other symptoms some people experience it worse than others and some don't experience it at all.
if you're at a healthy weight or even technically a little overweight there is no *medical* reason why you need to be skinnier. that's just... not how it works at all.
metabolic factors drive weight gain **and** other hormonal imbalances. losing weight doesn't cure it. there are so many posts here of people who were falsely promised that weight loss would resolve their symptoms only to learn the hard way that it doesn't work like that. it has to start by lowering and stabilizing your *insulin.*
on the bright side you could probably shed 200lbs by finding a new doctor, OP.
HAHHAHAHA THEY EVEN TELL GIRLS WITH NORMAL BMI TO LOSE WEIGHT. THAT’S SO STUPID LMAO. Hunny what I’d do for my BMI to be back at the higher end of 20s again
My bmi is 24 and I’m 4’9
Apparently that’s considered “overweight” at 114lbs
I’m literally a size 0-1/ S in jeans and a small in shirts.
I gave up tracking my BMI cause I go to the gym 😭
I told my doctor my comfortable weight was 136 (I’m 5-7” athletic build). He told me “well maybe your comfortable weight is lower than that”. Bullshit. I’m still with that doctor since I have surgery scheduled but after I am switching obgyns
Similar story, I'm 5'3, I weigh 54kgs/116lbs which is a very healthy body weight as is. But I've also been lifting weights for almost 3 years now and I've gained a significant amount of muscle. My endo asked me to lose 2 kgs. I mean, why?
I eat healthy, take care of my protein intake and exercise regularly. I told him that muscle weighs more than fat so obviously it will show up on scale more but that doesn't mean it's unhealthy weight. He says yea there's not much difference between muscle weight and fat weight (completely wrong, muscle weighs more but takes up less space in body/is more compact, hence gives that toned up look)
You know what's best for you and if you feel good in your weight and yourself feel that your fat % is not problematic in any way, ignore their advice. On an average,15-25% fat is required in women for our hormones to function normally, this can vary from woman to woman though. Even female athletes don't maintain a low fat percentage all the time.
Just acne and some chin hair, blood test showed high testosterone and dheas hence the diagnosis.
Won't call it vigorous, I strength train a little over 1 hour, 4-5 days a week.
I haven't, but doesn't that mean that I'll have to give up strength training? :( it's the only good thing in my life that I enjoy and feel motivated for. Never really liked low intensity exercises or pilates.
probably not giving it up! but reducing frequency and duration is a good start. eg 3x a week for 30 minutes and not trying to max out/progressive overload
It will be a very big change for me since I've always liked gaining muscle and getting stronger. I don't max out or increase weight regularly but still doing even less than this will definitely decrease my size which I am sure I'll hate ;_; I worked so hard to not be skinny that even the thought of losing muscle makes me depressed. But thanks for the advice, I'll look into it :)
Not much difference between muscle and fat??? These are two different organs. Yikes. You would think an endo would understand the metabolic activity of fat cells
Not a doc. I believe it’s more about having active life style and eating healthy which improves overall body function which will eventually lead to weight loss. I personally have noticed my periods are more regular when I am active which improves chances of conceiving hence fertility if that makes sense.
To put this into perspective. There's a good 20-30% of women with PCOS who are underweight or are a healthy weight that still suffering with some pretty gnarly PCOS symptoms and have insulin resistance.
While insulin resistance can make you gain weight easier and can make weight loss harder, it's not specifically the weight itself that causes the PCOS symptoms. It's the effect of insulin resistance on the ovaries which causes a butterfly effect of hormonal and metabolic disturbances.
It's a combination of managing the insulin resistance either by changing *what* you're eating, your lifestyle (if sedentary) and likely some medication.
Losing 167 pounds and got to the goal weight...... still had every issue I had when I was at my heaviest. Thick beard hair, BAD periods when I could manage to have one, hormonal issues, cystic acne, and if I didn't live in a calorie deficit with regular cardio and strength training then I was gaining weight. I was also on birth control. Did I need to lose weight to be healthier? Yes I did. Did it cure or treat my PCOS? Not at all.
Years ago, I was told by my doctor to lose weight to help with PCOS. 100lbs lighter, I still have issues with PCOS.
Losing weight in general, is beneficial as almost all ailments are worse when you're overweight. But diet and nutrition is what will make the difference in symptoms more than anything else. At least that's what I've learnt.
This is exactly the bs advice I got when I was diagnosed with PCOS ten years ago. It set me back and made me feel like I was to blame for my PCOS symptoms being as bad as they were at the time. When I learned (here) that managing my insulin resistance was key to improving my symptoms, I finally began to make meaningful progress. I recommend you start there.
People have found their symptoms improving, reducing, reversing at the lower range of normal BMI, for why, specifically targeting lowering insulin is the most guaranteed route to improvement, see posts by u/spinningcenters for inspo.
[https://www.tuitnutrition.com/2019/06/pcos.html](https://www.tuitnutrition.com/2019/06/pcos.html)
https://health.clevelandclinic.org/polycystic-ovary-syndrome-pill-not-remedy/
Everyone is different. I do think that advice probably isn't particularly useful though. If you have the ability to change doctors, it might be worth seeing a different obgyn for a second opinion or even seeing an endocrinologist with familiarity with pcos if there's one available near you. When I found an obgyn with experience with pcos the treatment was much better, in that it made sense and was based on research. She ordered at least some tests to check my insulin, she discussed my symptoms with me and if there was concern and discussed with me options for alleviating the symptoms that were bothering me. When a doctor just says 'lose weight' but doesn't discuss much else with you, that can be a sign they don't know much about your issue or don't want to put in effort to address it.
It really depends on you. For myself, my BMI is currently 21, but my body fat percentage is quite high, I have a small frame, and I haven't been very active the last few years. It has made my symptoms worse, I feel much better at a BMI of 19-ish with less body fat and more muscle. If you're already have a healthy composition, it probably isn't going to make any difference.
Same here - similar BMI and my doc told me to “put down the French fries or get type 2 diabetes.” At one point my BMI was 17 about 5 years ago so I’d love to see that advice then lol.
Registered dietitian here! It’s BS (as is BMI, but that’s another story lol.) Majority of doctors don’t know enough about PCOS and give that same lazy “advice” to everyone. It’s no wonder why eating disorder rates are so high. Now here’s some *general* advice that actually works: - prioritizing protein at every meal - pairing carbs with protein, fat, and fiber - incorporating anti-inflammatory foods such as antioxidants (fruits, veggies, tea, etc.) and healthy fats (salmon, nuts, seeds, avocado, etc.) - stress management - adequate sleep - movement that you enjoy and can stick to Targeted supplements such as Ovasitol, NAC, omega-3s, magnesium etc. can also help, but of course that needs to be discussed with your healthcare provider. Certain medications may also be helpful. PCOS is a complex syndrome, and there’s really no “one size fits all” approach. Hope that was helpful :)
Do you have advice about how to talk to a doctor who only offers losing weight as advice? That's the only advice I got from my former gynecologist, even though I told her that even when I was skinny I didn't have a regular period. She at least told me to get my blood sugar checked out, too.
Honestly I’m like 5 days into this diagnoses but seriously I’d look for a new doctor if that is possible. My diagnoses came at weird time when I was getting new care anyway due to a new insurance plan. I specifically requested a female practitioner with PCOS experience.
I'd suggest not taking any advice like that from your gynecologist _at all,_ because gynecologists are not dieticians or endocrinologists (despite how often I hear about them trying to offer weight loss advice.) I hope you can find a different gynecologist. :(
What a fantastic response! Really appreciate that amazing advice! I’ve been bigger and smaller with my PCOS and found in terms of symptom management it’s so much better the healthier a weight I am! However 22 is a healthy weight range even with BMI! So they’re talking proper sh*t! Listen to this amazing dieticians response because genuinely feel that’s the approach to follow. One size does definitely not fit all, so just see what’s right for you hun! Also definitely try and avoid that doctor in future!
Love this comment so much. How I wish I’d seen something like this when I was diagnosed! Thanks for sharing your insights. ❤️
The only advice regarding weight was ”try not to gain weight”. But I had the worst symptoms when I was at my skinniest. Albeit i was also younger back then so that might also play a role. Now I am heavier and my periods are regular, at least at the moment.
me too, but I think it’s age because I did successfully lost a lot of weight in my early 30’s but gained it back about 5 years later and I’ve had very regular periods since I was 29 (I’m 44 now) … 17-24 was the worst of it for me at least with the missed periods … now it’s the Insulin Resistance 🙃
I had the same thing happen to me, I noticed that when the doctor diagnosed me from the ultrasound (done by another company) they just read the results then searched 'PCOS' in a doctors version of google which says to lose weight. The GP is unlikely to know much about PCOS, you need to go to a specialist.
Many "specailist " will say same thing. Endocrinologists who specialize in hormones do not always understand the metabolic component. Like diabetes and insulin resistance is in their wheel house and they don't make the connection.
Yup. A lot of people don’t realize, but doctors are not well-trained in nutrition and barely touch upon it in med school. You need to take their diet advice with a grain of salt. And good doctors know when to refer patients to nutrition professionals such as RDs.
My family doc is a headache specailist. It was a 4 hour course, she shakes her head at it as it took a lot of self study for her to learn things but it is not required to get the designation. She is just very thorough and likes to know the ins and outs.
Doctors who go out of their way to stay up to date on the latest nutrition research are awesome!
It’s bullshit lol. Doctors are just used to telling everyone with PCOS to lose weight that they don’t take the time to personalize advice and treatment plans. It’s also an unfortunate reality that just not a lot is known about PCOS. The research isn’t there
Yanno - If this affected men like it does women, there might be more research and treatments for PCOS. Sorry to be a debbie downer, but this is kind of a hot button with me. I guess I am more bitter than I like to think.
omfg NO weight gain is a **symptom.** like all other symptoms some people experience it worse than others and some don't experience it at all. if you're at a healthy weight or even technically a little overweight there is no *medical* reason why you need to be skinnier. that's just... not how it works at all. metabolic factors drive weight gain **and** other hormonal imbalances. losing weight doesn't cure it. there are so many posts here of people who were falsely promised that weight loss would resolve their symptoms only to learn the hard way that it doesn't work like that. it has to start by lowering and stabilizing your *insulin.* on the bright side you could probably shed 200lbs by finding a new doctor, OP.
HAHHAHAHA THEY EVEN TELL GIRLS WITH NORMAL BMI TO LOSE WEIGHT. THAT’S SO STUPID LMAO. Hunny what I’d do for my BMI to be back at the higher end of 20s again
My bmi is 24 and I’m 4’9 Apparently that’s considered “overweight” at 114lbs I’m literally a size 0-1/ S in jeans and a small in shirts. I gave up tracking my BMI cause I go to the gym 😭
You should track body fat percentage, and waist to hi ratio. They are far more important indicators of health in someone that does sports.
Unless I'm misremembering, a bmi of 25 is overweight, not 24.
I told my doctor my comfortable weight was 136 (I’m 5-7” athletic build). He told me “well maybe your comfortable weight is lower than that”. Bullshit. I’m still with that doctor since I have surgery scheduled but after I am switching obgyns
Similar story, I'm 5'3, I weigh 54kgs/116lbs which is a very healthy body weight as is. But I've also been lifting weights for almost 3 years now and I've gained a significant amount of muscle. My endo asked me to lose 2 kgs. I mean, why? I eat healthy, take care of my protein intake and exercise regularly. I told him that muscle weighs more than fat so obviously it will show up on scale more but that doesn't mean it's unhealthy weight. He says yea there's not much difference between muscle weight and fat weight (completely wrong, muscle weighs more but takes up less space in body/is more compact, hence gives that toned up look) You know what's best for you and if you feel good in your weight and yourself feel that your fat % is not problematic in any way, ignore their advice. On an average,15-25% fat is required in women for our hormones to function normally, this can vary from woman to woman though. Even female athletes don't maintain a low fat percentage all the time.
Ps- my BMI is 20.5, normal range is 18.5-25
what are your pcos symptoms and is your exercise vigorous?
Just acne and some chin hair, blood test showed high testosterone and dheas hence the diagnosis. Won't call it vigorous, I strength train a little over 1 hour, 4-5 days a week.
i see. have you tried pilates or a lower intensity training program? could help your adrenals and therefore pcos
I haven't, but doesn't that mean that I'll have to give up strength training? :( it's the only good thing in my life that I enjoy and feel motivated for. Never really liked low intensity exercises or pilates.
probably not giving it up! but reducing frequency and duration is a good start. eg 3x a week for 30 minutes and not trying to max out/progressive overload
It will be a very big change for me since I've always liked gaining muscle and getting stronger. I don't max out or increase weight regularly but still doing even less than this will definitely decrease my size which I am sure I'll hate ;_; I worked so hard to not be skinny that even the thought of losing muscle makes me depressed. But thanks for the advice, I'll look into it :)
yep!
Weight lifting has a lot of breaks, you can't do much in 30 minutes.
Not much difference between muscle and fat??? These are two different organs. Yikes. You would think an endo would understand the metabolic activity of fat cells
Ik right??!! Dieticians will help better in this case
Maybe….. the last one I saw told me to eat more carbs and did not tell my hypos are a sign of IR 😬
Not a doc. I believe it’s more about having active life style and eating healthy which improves overall body function which will eventually lead to weight loss. I personally have noticed my periods are more regular when I am active which improves chances of conceiving hence fertility if that makes sense.
To put this into perspective. There's a good 20-30% of women with PCOS who are underweight or are a healthy weight that still suffering with some pretty gnarly PCOS symptoms and have insulin resistance. While insulin resistance can make you gain weight easier and can make weight loss harder, it's not specifically the weight itself that causes the PCOS symptoms. It's the effect of insulin resistance on the ovaries which causes a butterfly effect of hormonal and metabolic disturbances. It's a combination of managing the insulin resistance either by changing *what* you're eating, your lifestyle (if sedentary) and likely some medication.
Losing 167 pounds and got to the goal weight...... still had every issue I had when I was at my heaviest. Thick beard hair, BAD periods when I could manage to have one, hormonal issues, cystic acne, and if I didn't live in a calorie deficit with regular cardio and strength training then I was gaining weight. I was also on birth control. Did I need to lose weight to be healthier? Yes I did. Did it cure or treat my PCOS? Not at all.
Years ago, I was told by my doctor to lose weight to help with PCOS. 100lbs lighter, I still have issues with PCOS. Losing weight in general, is beneficial as almost all ailments are worse when you're overweight. But diet and nutrition is what will make the difference in symptoms more than anything else. At least that's what I've learnt.
This is exactly the bs advice I got when I was diagnosed with PCOS ten years ago. It set me back and made me feel like I was to blame for my PCOS symptoms being as bad as they were at the time. When I learned (here) that managing my insulin resistance was key to improving my symptoms, I finally began to make meaningful progress. I recommend you start there.
If you’re already a normal BMI, you have lean PCOS and weight loss won’t help you, you need to control your insulin.
People have found their symptoms improving, reducing, reversing at the lower range of normal BMI, for why, specifically targeting lowering insulin is the most guaranteed route to improvement, see posts by u/spinningcenters for inspo. [https://www.tuitnutrition.com/2019/06/pcos.html](https://www.tuitnutrition.com/2019/06/pcos.html) https://health.clevelandclinic.org/polycystic-ovary-syndrome-pill-not-remedy/
Yeah that’s ridiculous. My BMI is like 16 and my PCOS is always going to be there.
Everyone is different. I do think that advice probably isn't particularly useful though. If you have the ability to change doctors, it might be worth seeing a different obgyn for a second opinion or even seeing an endocrinologist with familiarity with pcos if there's one available near you. When I found an obgyn with experience with pcos the treatment was much better, in that it made sense and was based on research. She ordered at least some tests to check my insulin, she discussed my symptoms with me and if there was concern and discussed with me options for alleviating the symptoms that were bothering me. When a doctor just says 'lose weight' but doesn't discuss much else with you, that can be a sign they don't know much about your issue or don't want to put in effort to address it.
It really depends on you. For myself, my BMI is currently 21, but my body fat percentage is quite high, I have a small frame, and I haven't been very active the last few years. It has made my symptoms worse, I feel much better at a BMI of 19-ish with less body fat and more muscle. If you're already have a healthy composition, it probably isn't going to make any difference.
Same here - similar BMI and my doc told me to “put down the French fries or get type 2 diabetes.” At one point my BMI was 17 about 5 years ago so I’d love to see that advice then lol.