This is an often asked question when trying to work out what’s best to do when first diagnosed with PCOS.
It generally stems from the advice to lose weight, which is the first guideline in how to manage PCOS from NICE (National Institute for Health and Care Excellence). This is what GPs use to navigate dealing with the condition.
Studies have shown that weight loss has been shown to improve certain aspects of PCOS, which is why this the advice, however this is nuanced. It’s should not be weight loss at all costs. By restricting foods and nutrients, more harm can come rather than any benefit.
Diet culture has led us to believe that losing weight needs to include a restrictive mindset, is unpleasant and leads to shame and guilt if you can’t ‘follow the diet plan’.
This isn’t to say that weight loss might not help, it really can make a difference for some women and it can form part of a more holistic plan.
Fat cells are hormonally active so it can help create more hormonal balance to reduce the amount of fat cells you have.
If we decide to make a plan to lose weight, the challenge then comes of how and this stumps many women with PCOS. It can feel ridiculously hard.
A problem can be we can go in with an all or nothing mentality; we’re going to stop eating XYZ and lose 2kg a week etc etc. We want it all to be fast and easy and are sold the dream that you can eat 800 calories a day and keep on happily moving through life. We all know this isn’t the case.
PCOS can be a tricky customer. She doesn’t like being starved. She will fight back. Most diet plans are not made with PCOS women in mind and she’ll happily let you know that.
So knowing that, you’re probably like what on earth do I do then?
The answer is you’re going to have to get to know your body and then try some stuff out, but there are some things you should have in your mind.
The reason is, there isn’t a one size fits all, and whatever you choose to do, PCOS is with you for life so you need it to be sustainable.
Where to start when making a plan to lose weight with PCOS
There are some general principles to eating that can really help support your body get back into balance. A key part to think about is ensuring you’re getting the right nutrients that will help support your body and forming a positive relationship with food. This can be hard if you have come from a dieting focused background and will take time to work through.
Be patient with your mind and body.
There’s a number of factors to consider
PCOS is a hormonal imbalance condition. In order to get your hormones working successfully your body needs to think it’s safe and your hormones systems can communicate successfully. This is why stress management is such a key part of PCOS management.
Focusing on the food though, your body needs certain nutrients to be able to:
a) produce the hormones
b) allow the hormones to talk to each other
c) make the hormones in the right amounts
So the question isn’t what’s the best diet: it’s what’s the best nutrition for PCOS?
- Ratios between protein / fat and carb can be important. Ensuring you get enough protein per day is important – aim for around 1g per kg of your weight. Look at the type of fats you’re eating and consider your carb choice and your carb portions – more on that below.
- Ensure every meal and snack has protein
- Choose healthy fats especially those rich in Omega 3 such as oily fish and flaxseeds
- Reduce processed foods
- Reduce sugar coming into your diet
- Be mindful around carbohydrates – switch to wholegrains and complex carbohydrates
- Increase fibre = eat more vegetables
- Include fruit but eat it in it’s whole, fresh form rather than juiced or dried.
Do I need to give up carbs?
No. You don’t. Carbs can be confusing but they aren’t your weight gain nemesis. First of all, vegetables are carbs and no one should be giving up vegetables. Secondly carbs such as pasta, bread and rice can come in lots of different forms and you can still eat them. The thing you want to think about is quantity and what you’re eating them with.
Because the underlying cause of PCOS is very often insulin resistance, known to be around 70%-80% of women, the science ways very heavily in favour of focusing on blood sugar balance as the key way to improve your bodies function.
What can muck up blood sugar balance?
Simple carbs eaten with limited protein and fat.
What’s an example of this? White pasta with plain tomato sauce (an old favourite of mine).
There are always other factors to consider but these are a good place to start.
If you’re building your meals today using these principles you could think about eating like this:
PCOS meal ideas:
Breakfast: Smoked salmon and eggs (protein and omega 3 fat) Spinach (fibre) Wholegrain seeded toast (complex carb)
Snack: Hummus with carrot sticks and 2 oatcakes
Lunch: Chicken salad with quinoa
Snack: Apple with nut butter. 2 pieces dark chocolate (over 70%)
Dinner: Roast salmon fillet, steamed broccoli, peas, new potatoes.
Add in some movement, the goal of 10,000 steps is a helpful target but just add in what you can.
If you like the structure of going to a gym, do that. If that’s not for you, borrow a friends dog, get off the bus one stop further away, meet a friend for a walk rather than a coffee (or walk with a coffee!).
It can feel overwhelming and frustrating but just think about the next meal you’re going to eat and apply these principles.
You will probably have to adapt what you’re currently doing and that can be hard but change is possible.
This is coming from a woman who ate a bagel with jam washed down with a diet coke for breakfast, lived off crisps and chocolate and had never include broccoli in her diet. If I can do it, so can you.
Your body wants nutrients and to be fed with whole nutrient dense food, that's the ideal 'diet' for PCOS. Then it can get on with being amazing.