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Women with PCOS are more likely to be overweight or obese and their symptoms worsen further.
What is causing this weight gain? How can weight loss help? And how can women lose the extra pounds to improve what they describe as painful symptoms?
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PCOS is the most common hormonal disease in women of childbearing age. Symptoms include irregular menstruation or signs of high levels of male hormones, such as excessive hair growth or severe acne.
Women find it difficult to manage these symptoms because they feel that their feminine identity is in question. They also report a lack of support from health professionals and their peers and worry 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 to be obese (with a body mass index of 25 kg / m² and over) compared to unconditioned women . And they gain more weight per year (260 g more) than women without PCOS the same age. Many women with PCOS also have difficulty losing or maintaining weight.
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Does weight gain worsen the symptoms of PCOS?
Heavier women with PCOS usually have more severe symptoms. The question is whether weight gain worsens symptoms or if PCOS itself causes weight gain in women.
To prove that weight gain worsens the symptoms of PCOS, we need studies in which women have to gain weight and whose symptoms are monitored to detect any changes. We doubt that such a study was conducted because of ethical issues related to the potential harm suffered by the participants. Not to mention the difficulties in recruiting women for a study in which they would gain weight. We must therefore look for other forms of evidence.
An observational study conducted in Finland showed that an increase in BMI in women aged 14 to 31 years was associated with a higher likelihood of irregular menses, excessive hair growth, or PCOS diagnosis. .
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And when women with PCOS lost weight because of lifestyle changes, such as eating less or increasing their physical activity, a Cochrane review showed a reduction in male hormones and excessive hair growth.
Given the above, we may conclude that weight gain is likely to worsen the symptoms of PCOS.
Does PCOS cause weight gain or prevent you from losing weight?
Many women with PCOS report having a lot of trouble losing weight, but we do not quite understand why.
Women with PCOS have the same metabolic rate as women without PCOS. They consume a few more calories (about 200 kilojoules a day, the equivalent of a cheese cube) compared to women without PCOS. This could lead to taking an extra 2-3 kg over a year.
Women with PCOS can have different levels of hormones that control appetite, and high levels of male hormones could increase appetite for high fat foods.
But with similar support, women with and without PCOS lose the same weight.
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Beyond PCOS, all women of childbearing age seem to be gaining small but persistent weight. Women earn on average up to 600 g per year from 18 years. Married or couple women who start work or have children are more likely to gain weight.
The reasons why women gain weight could be related to difficulties in 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 difficulties when they describe ongoing stress related to PCOS symptoms, such as unpredictable periods.
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Women with PCOS also have higher levels of anxiety and depression and a lower quality of life, which can compromise their ability to adopt a healthy lifestyle.
Recent focus groups we conducted revealed that women with PCOS reported "a yo-yo dieting lifestyle" with repeated cycles of weight loss followed by weight gain. Often these cycles lead to overall weight gain over time.
What should I do if I have PCOS?
Instead of following an unsustainable diet, which could lead to a weight cycle and a feeling of defeat, aim for small changes (and therefore durability) in the diet and exercise.
Find something you like. Set the overriding goal of maintaining your weight and improving your health, no matter what happens now.
Tracking your weight by weighing yourself regularly (once a week, for example) can help you. If you have regular medical appointments, asking your doctor to monitor your weight changes between visits can also help you maintain your weight.
If you are 25 years old now, keeping your current weight would be equivalent to permanently losing more than 20 kg at age 50. We know that it is almost impossible. Keeping the same weight is a much more achievable and equally beneficial goal.
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