6 Reasons It’s Harder to Lose Weight With PCOS
If you’ve been working hard to eat well, exercise, and still feel like your body isn’t responding the way it “should,” you’re not alone. For women with PCOS (polycystic ovary syndrome), weight loss can feel incredibly frustrating and as someone with PCOS, I’ve been there and totally get it!
You’re doing all the things but the scale won’t budge, your clothes feel tighter, or that stubborn PCOS belly just won’t go away. The good news? There are ways to fix this once you understand a bit more about PCOS and how our bodies work differently than most. Your body is working differently because of your hormones and once you understand why, you can finally start working with your body instead of against it.
Let’s break down exactly what’s going on, why it’s harder to lose weight with PCOS, and what you can do to finally see progress.
What Is PCOS & What Are The Main Signs?
Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions affecting women of reproductive age. It’s driven by a mix of hormonal imbalances, including high androgens (like testosterone), insulin resistance, and sometimes irregular ovulation.
Common signs and symptoms of PCOS include:
Irregular or missed periods
Weight gain or difficulty losing weight
Acne or oily skin
Hair thinning on the scalp
Excess hair growth on the face or body
Fatigue, anxiety, or mood swings
Trouble with fertility
While there are different “types” of PCOS (like insulin-resistant, adrenal, or post-birth control PCOS), one of the most common struggles across all types is weight management.
6 Reasons It’s Harder to Lose Weight With PCOS
Let’s get into WHY your body might be holding onto weight despite your best efforts, and what’s actually happening under the surface.
1. Insulin Resistance & PCOS
Insulin resistance is one of the most common root causes of PCOS weight loss struggles. It’s estimated that up to 80% of women with PCOS experience insulin resistance, even if they’re not overweight. This makes blood sugar regulation harder, increasing fat storage—especially around the abdomen. (Dunaif A. et al., Endocrine Reviews, 1997).
Insulin is the hormone that helps your body move glucose (sugar) from your blood into your cells for energy. When you have insulin resistance, your cells stop responding efficiently to insulin. This causes your body to produce more of it, leading to:
Elevated blood sugar levels
Increased fat storage (especially around the belly)
Intense sugar cravings
Energy crashes after meals
This is why you might notice that even when you eat “healthy,” your energy feels unstable or your hunger cues are all over the place.
To support insulin sensitivity:
Eat balanced meals with at least 30g+ of protein, healthy fats, and fiber at each meal
Eat some fiber filled veggies before your main meal (like artichoke hearts, a small spinach salad or carrots & hummus) to limit glucose spikes
Avoid skipping breakfast or going long stretches without food
Try gentle movement after meals, like a short walk
Consider PCOS supplements for weight loss like inositol or berberine, which can help regulate blood sugar and improve insulin sensitivity
2. How High Cortisol Levels Impact PCOS Weight Loss
Cortisol is your main stress hormone, and when it’s constantly elevated (from emotional stress, poor sleep, under-eating, or over-exercising), it signals your body to hold onto fat, especially around your midsection. Research shows that women with PCOS often have higher baseline cortisol levels and a stronger stress response, which can promote abdominal fat storage and worsen metabolic symptoms. (Stener-Victorin E. et al., J Clin Endocrinol Metab, 2005)
This is why so many women with PCOS experience the classic PCOS belly, which can be a mix of insulin resistance, inflammation, and high cortisol levels.
When cortisol is high, your body thinks it’s in survival mode, so it prioritizes safety over weight loss, leading to:
Blood sugar spikes and crashes
Intense sugar or carb cravings
Difficulty sleeping
Fatigue or afternoon energy slumps
To lower cortisol naturally:
Prioritize sleep (7–9 hours per night) and avoid screens at least 30 mins before bed and after you wake up to help regulate your circadian rhythm
Avoid intense cardio every single day. Make sure to mix in yoga, walking, or Pilates, especially in your luteal phase. If your period is missing, avoid high intensity cardio and workouts altogether as that’s a sign your cortisol levels are already high.
Eat balanced meals on a consistent schedule
Incorporate daily PCOS self-care routines like meditation, journaling, or breathwork to calm your nervous system
3. Hormone Imbalances That Slow Down Metabolism
In PCOS, hormones like estrogen, progesterone, testosterone, and thyroid hormones can all become imbalanced much more easily. These imbalances can slow down your metabolism and make it harder for your body to burn fat efficiently. (Diamanti-Kandarakis E. & Dunaif A., Endocrine Reviews, 2012)
For example:
Low progesterone can cause bloating, fatigue, and water retention
High testosterone can lead to more abdominal fat and insulin resistance
Thyroid imbalances can reduce metabolism and energy output
This combination can leave you feeling like you’re doing everything right, but your body just isn’t responding.
Supporting hormone balance starts with the basics: steady blood sugar, stress management, and a PCOS diet for weight loss that focuses on whole foods, quality protein, and plenty of fiber.
4. The Impact of Inflammation on PCOS
Chronic inflammation is a silent driver behind many PCOS symptoms, including stubborn weight gain. Inflammation increases oxidative stress, disrupts insulin sensitivity, and interferes with how your body uses energy. (González F., Steroids, 2012)
You might not feel inflamed, but signs can include bloating, fatigue, joint pain, skin breakouts, or digestive issues.
To reduce inflammation:
Focus on anti-inflammatory foods like leafy greens, salmon, berries, olive oil, and turmeric
Limit processed foods, refined sugar, and seed oils
Stay hydrated and move your body daily
Prioritize rest and recovery. Stress is one of the biggest factors of inflammation!
Reducing inflammation not only supports weight loss but can also help with acne, energy, and mood stability.
5. Sleep & Energy Levels
Poor sleep is one of the most underrated barriers to PCOS weight loss. When you’re sleep-deprived, your hunger hormones (ghrelin and leptin) become dysregulated, increasing cravings for high-carb, high-sugar foods. Unfortunately, women with PCOS are even more likely to experience sleep disturbances and fatigue, which can further raise cortisol and disrupt glucose metabolism. (Tasali E., Van Cauter E., & Ehrmann D.A., J Clin Endocrinol Metab, 2008)
Tips for better sleep:
Keep a consistent sleep schedule
Avoid screens at least 30 minutes before bed & 30 mins after waking
Get outside in the mornings when the sun is up, even if it’s cloudy! Stepping outside and getting natural light can help regulate your circadian rhythm
Create a calming bedtime ritual (stretching, herbal tea, magnesium)
Keep your room dark, cool, and quiet
Better sleep = better blood sugar control, fewer cravings, and a calmer nervous system.
6. Intense Cravings Make It Harder to Stay Consistent
Ever feel like your cravings completely take over in the second half of your cycle or after a long day? That’s not a lack of willpower, it’s your hormones and blood sugar talking.
Insulin resistance, blood sugar instability, and fluctuating progesterone can all trigger cravings for comfort foods. The problem is, giving in to these constantly can create more blood sugar spikes, leading to even higher insulin levels and more fat storage.
Instead of restriction, focus on balance:
Eat protein and fat with every carb to slow down glucose spikes
Don’t skip meals (it backfires later)
Manage stress, since cortisol-driven stress eating is common with PCOS
Keep healthier swaps on hand (like dark chocolate, berries, or Greek yogurt with cinnamon)
Consistency becomes much easier when your meals are blood sugar-balanced and you’re not running on stress hormones.
How to Lose Weight with PCOS
Now that you understand why it’s harder to lose weight with PCOS, let’s talk about how to make it possible sustainably, and without restriction.
1. Focus on Blood Sugar Balance
Every meal should include a protein, healthy fat, and fiber in addition to natural carbs. This helps reduce insulin spikes, curb cravings, and stabilize energy.
2. Strength Train Regularly
Muscle tissue improves insulin sensitivity and supports metabolism. Strength training 2-3 times per week can help shift body composition even if the scale doesn’t move right away.
3. Prioritize Stress Management
Cortisol directly affects insulin, inflammation, and fat storage. Daily stress-reducing practices, even five minutes of deep breathing, can make a huge difference in naturally lowering cortisol levels and bringing your nervous system back down to rest & digest.
4. Consider Targeted Supplements
Some PCOS supplements for weight loss can be beneficial when used correctly. Make sure you know the right dosage and get a clean brand so that you’re not just adding more toxins into your body.
Inositol (myo- and D-chiro forms) for insulin balance
Magnesium glycinate for stress and sleep. I loveee the Raena brand - you can use code MADDY10 to save!
Omega-3s for inflammation
Vitamin D to support metabolic and hormone health
Berberine: A plant compound shown to improve insulin resistance and support healthy blood sugar balance. Studies have found it to be as effective as metformin for some women with PCOS. (Natural Medicine Journal)
Always work with your practitioner to customize what’s right for you!
5. Nourish, Don’t Punish
Your body doesn’t respond to restriction. It responds to nourishment. Overly restrictive diets can raise cortisol and slow metabolism further. A PCOS diet for weight loss should be realistic, satisfying, and hormone-friendly.
6. Practice PCOS Self-Care
Self-care isn’t optional with PCOS, it’s a MUST. Whether that means journaling, slowing down, taking walks outside, or setting boundaries, your stress response is directly tied to your hormones.
Healing your hormones is just as much about mindset as it is about nutrition and working out.
Losing weight with PCOS isn’t impossible, it just requires a different approach. Your body isn’t fighting you; it’s asking for balance. By addressing insulin resistance, cortisol, inflammation, and lifestyle factors, you can finally start seeing the changes you’ve been working for.
If you’re ready for personalized support, you don’t have to do it alone. Inside the Becoming Balanced Together (BBT) community, you’ll get access to hormone-balancing meal plans, PCOS-friendly strength workouts, and mindfulness practices designed specifically to help you rebalance your hormones and feel better in your body.
Or, if you want more personalized guidance, my 1:1 hormone health coaching program offers personalized nutrition, movement, and self-care support tailored to your unique PCOS journey.
Your body isn’t broken, it just needs the right environment to thrive. Let’s get you there, together!
Sources
Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews. 1997;18(6):774–800.
Diamanti-Kandarakis E., Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine Reviews. 2012;33(6):981–1030.
Stener-Victorin E., Jedel E., Mannerås L. Acupuncture in PCOS: cortisol and sympathetic nerve activity. Journal of Clinical Endocrinology & Metabolism. 2005;90(8):4883–4890.
González F. Inflammation in polycystic ovary syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012;77(4):300–305.
Tasali E., Van Cauter E., Ehrmann D.A. Relationships between sleep disordered breathing and glucose metabolism in PCOS. Journal of Clinical Endocrinology & Metabolism. 2008;93(11):3989–3996.
Natural Medicine Journal. Berberine Compared to Metformin in Women with PCOS: improvements in fasting glucose and insulin resistance comparable to metformin.