Lifestyle, eating and physical activity guidelines are the first treatment for this common hormonal condition that affects about 20% of women. Unfortunately this can become ‘lose weight’ – which is often not even relevant.
About 40 % of women with PCOS don’t even have a weight issue, but they still need to reduce their risk of metabolic complications like heart disease. Other women with PCOS have tried everything possible around their weight and nothing has worked for very long.
The starting point is actually to shift the focus away from weight to being ‘healthy in your own bones’ – and ditch population based measures like the BMI which don’t suit the individual.
The next thing is to focus on managing normal blood glucose (sugar) swings over the day so they lead to more even and lower insulin production. There are a lot of theories out there about what to eat that have no basis in evidence. Basically the aim is to sensibly distribute food over the day with well balanced meals and snacks, and then to add regular enjoyable physical activity to improve insulin sensitivity.
Symptoms like mood swings, food cravings and tiredness should improve with all this. Then mindful eating practices can be learnt to help with judging the amount of food to eat. This is often not possible when hormones and appetite signals are too chaotic.
Don’t forget though that there are often body image, self esteem and eating or mood problems to be addressed along the way. PCOS is after all a bad name for a wide collection of symptoms and all women need their own answers to their individual hormonal concerns.