Obesity is present in 44 percent of women with PCOS. As I told you earlier in this chapter, being overweight worsens the symptoms of PCOS by increasing insulin resistance and further elevating levels of male hormones. Because of this, weight loss is one of the main goals of treatment for PCOS. In fact, studies find that losing more than 5 percent of body weight can restore fertility in obese women with PCOS.1 For a woman who weighs 180 pounds, this means losing at least 9 pounds—very do-able!
I strongly recommend that you consult with a registered dietitian to help you lose weight safely and effectively. To find a private practice dietitian in your community check out www.eatright.org. Working one-on-one with an expert means you will get an eating plan that is customized to your schedule and food preferences. Regular follow-up visits allow you to monitor your progress, adjust your plan as needed and discuss ways to overcome challenges and potential obstacles to success. I see many women in my private practice with PCOS who successfully lose weight. See my weight-loss tips in chapter 2 to help you get started, and pay special attention to the following:
1. Reduce your portions of carbohydrate-containing foods. Low-carbohydrate diets are recommended with PCOS. Eating smaller portions of carbohydrates not only reduces your calorie intake, it also helps to reduce high levels of blood insulin. That’s because, once digested into glucose units, carbohydrate foods trigger the release of insulin in the bloodstream. But don’t give up all carbohydrate-containing foods. I do not recommend diets like Dr. Atkin’s or Protein Power, where followers are told to avoid all starch, fruit and milk products. Over the long run this is not healthy, nor is it sustainable.
Managing Polycystic Ovary Syndrome PCOS DIETARY STRATEGIES Weight Loss Photo Gallery
2. Get rid of excess sugar—natural and refined. Too much sugar in the diet contributes to high blood triglyceride levels, something that a number of women with PCOS show on blood tests.
Low Glycemic Carbohydrates for Polycystic Ovary Syndrome (PCOS)
Unfortunately, insulin resistance makes weight loss more difficult to achieve. To help improve insulin resistance and lower blood insulin levels it is important to eat smaller portions of carbohydrate-rich foods and choose the right types of carbohydrate foods. When you eat a carbohydrate-rich food, whether it’s pasta, yogurt, an apple or fruit juice, the carbohydrate is broken down into glucose and absorbed into your bloodstream. Your blood sugar rises, and this tells your pancreas to release insulin into the blood. Insulin then clears sugar from your blood, taking it into your cells, where it’s used for energy. If you have insulin resistance, insulin cannot perform this task properly. Some sugar remains in the blood, causing more insulin to be released. This can result in a chronically high insulin level.
You’re probably wondering what the type of carbohydrate food has to do with it all. Well, it turns out that carbohydrate foods are digested and absorbed at different rates. Some foods are digested slowly and result in a steady, slow rise in blood sugar. That means that less insulin will be secreted into the blood. Slow carbohydrates have what is called a low glycemic index. Foods with a high glycemic index are digested and absorbed more quickly and cause much higher insulin levels.
It’s probably obvious by now that your meals and snacks should emphasize foods with a low glycemic index (for a list of foods ranked by their glycemic index value, see page 97 in chapter 5, “Hypoglycemia”). Use the chart below to help you replace higher glycemic carbohydrates with lower glycemic ones.
HIGH GLYCEMIC FOOD LOW GLYCEMIC FOOD
Bread, white or whole-wheat Whole-grain pumpernickel, whole-grain rye sourdough
Most processed breakfast cereals 100% bran (All-Bran, Bran Buds), (Corn Flakes, Puffed Rice, Special K) Mueslix, oatmeal
Instant rice Brown rice, basmati rice
Mashed potato Pasta or beans or sweet potatoes
Bananas Apples, oranges, peaches, nectarines
Snack foods: crackers, cookies, chips Low-fat smoothie, yogurt, milk, latte, dried apricots, fruit (as above), popcorn
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