Here’s why women with PCOS struggle with their weight.
“I’ve followed other diets to the letter and can’t seem to lose more than a few pounds.” That is often what I hear women say when they have PCOS. Polycystic ovarian syndrome (abbreviated as PCOS) is a genetic condition which affects a woman’s hormone levels and how her ovaries work. The two main hormones affected by PCOS are insulin and testosterone. The symptoms include irregular periods and difficulty getting pregnant.
To understand PCOS, you need to understand how insulin works. I’m going to use an analogy that most people can relate to – buying food at the supermarket. You know what it is like…the number of people in the store, the number of checkouts that are open and number of cashiers available, all dictate how long everyone needs to stand in line waiting to pay for their shopping. Sometimes there are lots of checkouts open, the cashiers are really speedy and you can sail right through in no time. Other times, there are a million people in the store, all of whom want to check out at the exact same moment that you do and inevitably, there is only one checkout open and there is a trainee working on the till. I hate it when that happens! And in these situations, it takes a really long time to get through the checkout and out the door. Are you with me so far?
Now let’s pretend that blood sugar is represented by the number of people shopping in the store and insulin is represented by the number of cashiers available. So eating starchy or sweet foods causes an increase in blood sugar levels which is just like unleashing a bunch of shoppers into the grocery store all at the same time. If your body is in top working condition, it will release exactly the right number of cashiers and open exactly the right number of checkouts to match the number of people in the store. When that happens, the store will clear out in no time (blood sugar levels return to normal) and everyone is happy. But for people with PCOS (even if they are at a healthy weight), while they have enough cashiers working at the store, the store was built with only enough room for 2 checkout counters. That means no matter how many cashiers they hire for that store, they will only ever have two checkouts open at a given time. That means if people with PCOS eat lots of starchy and sweet foods, it is going to take a really long time for all of those shoppers to get through the checkout and for the store to clear out again. If the person with PCOS gains weight, this causes one of the tills to stop working, so now there is only one checkout open for the entire store. No matter how many cashiers are available, it won’t make any difference because there is still only one checkout open. As you can well imagine, it will now take even longer for all of the shoppers in the store to pay for everything and leave.
So to summarise, women with PCOS tend to have high levels of insulin (lots of cashiers) but their body is resistant to insulin and won’t let insulin do its job (not enough checkouts). Having lots of insulin in the body is not good for many reasons, but in this case, high levels of insulin also cause a woman with PCOS to produce excess levels of testosterone. Excess testosterone is responsible for the facial hair, acne, extra belly fat, irregular periods and infertility which create so many problems for these women. Think of it this way, the store has too many cashiers (insulin) not doing what they are paid for. So while these cashiers are sitting around doing nothing, they are texting their boyfriend (testosterone) to come over to the store and hang out with them. Since the cashiers tend to fall for the bad-boy type when it comes to men, the store is now overrun with boyfriends who start causing all sorts of havoc (think facial hair, acne, extra weight around your belly, irregular periods and infertility).
So what does this have to do with weight? Quite a lot actually. Because many popular slimming clubs suggest that potatoes, rice, pasta, bread and fruit are “free” foods, and so women often eat them in excess trying to stop themselves from being hungry. That is basically like sending 100 shoppers into the supermarket at the same time knowing full well that there is only one checkout open. This will cause insulin levels and testosterone levels to increase and problems are going to arise.
So what is the answer then?
1. Be careful not to eat more food than what your body needs. Listen closely to your body’s cues for physical hunger and seek help for emotional eating if this is something that you struggle with.
2. If you have PCOS and your diet consists of foods like toast or cold cereal for breakfast, a sandwich and crisps for lunch and pasta with tomato sauce for your evening meal, some dietary adjustments can help. Women with PCOS often need to reign in the amount of toast, cold cereal, sandwiches, potatoes, pasta, rice, biscuits and cakes that they eat so that they don’t overload the store with too many shoppers at one time. Note: I didn’t say they need to cut these foods out completely, I just said they need to reduce the amount eaten at one time. As you can imagine, a cashier is perfectly capable of dealing with one shopper per hour, they just can’t deal with 100 people converging on them all at the same time. Eating more vegetables and a bit more protein at mealtimes can help someone feel full without having to eat more starchy or sweet foods.
3. Women with PCOS tend to respond better when they choose starchy and sweet foods which are considered “slow release” like lentils, baked beans, barley, basmati rice, whole wheat pasta, quinoa, granary/seeded bread, milk, yogurt and berries. These foods are like only letting a few shoppers into the store at a time. This makes it easier for the cashiers and checkouts to keep up with the demand.
4. Being physically active for at least 150 minutes per week, helps insulin work better. It’s like building extra checkout counters so the cashiers that you have loitering around can actually do what they are paid to do and get the shoppers out of the store as quickly as possible. The more physical activity you do, the more checkout counters your body builds and the faster the shoppers get out of the store. Strength training activities help the most.
I hope this analogy has been helpful. This is a new way of explaining PCOS and insulin resistance so please comment below and let me know if you found it helpful or if you need more clarification on certain points.
For more personalised help on how to adjust your food intake to manage PCOS, hormone levels, blood sugar and weight, please get in touch using the contact form below.