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By Britni Thomas, RD, LD
April 13, 2017
You may not have heard of PCOS (polycystic ovarian syndrome), but it is one of the most common endocrine disorders in women and is the number one cause of infertility for women. You may even know somebody who has PCOS since it affects 5 – 10% of women in the United States and at least 50% of women go undiagnosed.1,2 Symptoms can include weight gain, difficulty losing weight, acne, infertility, hair loss, depression, irregular menstrual cycles, excessive growth of facial or body hair (hirsutism) and ovarian cysts. It is a complex condition that affects the body systemically and that’s often misunderstood. The “typical” woman with PCOS is obese, has acne, thinning hair, excess body hair and irregular menstrual cycles. Many practitioners believe that if a woman doesn’t exhibit those symptoms that she doesn’t have PCOS which is just not true—experts now believe there are different kinds of PCOS. As mentioned above symptoms vary, but weight gain is one of the most common so let me tell you why.
Insulin resistance is the root of the problem for most women with PCOS, and some believe it may be the cause. At least 50% of women with PCOS are overweight or obese and gain weight very easily.3 At Nutritional Weight & Wellness we often talk about insulin resistance, but you may not know exactly what that is. To explain, let’s back up and talk about what should happen with a healthy metabolism. First, when you eat carbohydrates your blood sugar spikes and your pancreas naturally puts out insulin. Then insulin grabs onto the glucose in the bloodstream and carries it into the cells. Insulin acts like a key to unlock the door of the insulin receptors and carry glucose into the cell to convert it to energy. Insulin is our primary fat storage hormone and is also a master hormone, which means it affects many different areas of the body.
Now for insulin resistance, that occurs when your cells have developed a crust over the top, which blocks insulin from carrying the glucose into your cells efficiently. Then your body needs to make more insulin to compensate. At that point you aren’t getting as much glucose into the cells, which triggers your body to want more sugar. Your body thinks that if you eat more sugar you’ll be able to turn more glucose into energy. The more insulin your body makes the more fat is stored, and it easily turns into a vicious cycle of eating more sugar and storing more weight.
Women with PCOS seem to have a defect in their insulin-signaling pathways, which means they easily become insulin resistant. Insulin resistance will then affect sex hormones and can lead to the other symptoms of PCOS listed above. Women with PCOS have about a seven times greater risk for developing type 2 diabetes and are also at a greater risk for cardiovascular disease. Dr. Gersh, a leading expert on PCOS and an integrative gynecologist, supports the idea that women with PCOS are very sensitive to sugar and explains that when a woman with PCOS consumes carbohydrates it “triggers an explosion of inflammation”.
The good news is— there is hope! You can reverse insulin resistance through diet. If you have PCOS and reverse the insulin resistance, you need to continue to be diligent about your nutrition because your body can very easily become insulin resistant again. By now you’re probably wondering “Well how do I do that.” Well, you need to eliminate or extremely limit processed carbohydrates (pasta, bread, crackers, cereal, baked goods, etc). Replace those processed carbs with lots of vegetables. The extra fiber in vegetables will help to keep your blood sugar stable. Next, remember that fat is your friend! Fat has no effect on blood sugar so it helps to keep your blood sugar stable and decreases the amount of insulin your body produces. That means your body can start burning fat instead of storing it. You should be eating a generous amount of fat every time you eat (butter, avocado, nuts, olive oil, coconut oil, olives).
I have PCOS and can proudly say that through diet and proper supplementation I have been able to keep my symptoms at bay. I know that my body is much more sensitive to carbohydrates, so I have to be diligent about my nutrition every single day. If I go off track much it becomes very easy for me to gain weight.
If you know anybody struggling with infertility or any of the symptoms discussed above, please share this article. It may provide some answers they’ve been looking for. If you have PCOS, I highly recommend scheduling an appointment with a nutritionist. I believe that women with PCOS need more support and somebody to help them figure it all out! For more information please listen in to a recent Dishing Up Nutrition where we took a deep dive into PCOS.