Why Weight Loss Is Not a Treatment for PCOS
If you’ve been diagnosed with PCOS, there’s a good chance weight loss was presented as the solution.
“Just lose some weight.” “Even 5–10% can improve symptoms.” “PCOS is easier to manage if you’re thinner.”
This framing is so common that many people leave appointments believing their body is the problem rather than a complex endocrine condition that deserves real care.
I want to be very clear here: weight loss is not a treatment for PCOS. And for many people, pursuing weight loss can actually make PCOS symptoms worse.
PCOS Is a Hormonal and Metabolic Condition, Not a Weight Problem
Polycystic Ovary Syndrome (PCOS) is a endocrine condition involving:
Insulin resistance (in many, but not all, cases)
Elevated androgens
Irregular ovulation
Altered stress hormone signaling
Genetic and environmental influences
None of these are caused by body size.
People with PCOS exist across the weight spectrum. Thin people get PCOS. Fat people get PCOS. Weight does not determine severity, symptoms, or outcomes.
When weight loss is positioned as treatment, it shifts attention away from what actually matters: how the body’s systems are functioning.
The Problem With Weight-Centered PCOS Care
Weight-loss-focused care often assumes:
Higher weight causes PCOS symptoms
Smaller bodies are inherently healthier
Restriction and control will “fix” hormones
But here’s what we see clinically and in research:
1. Weight Loss Does Not Address Root Causes
Weight loss does not treat:
Insulin resistance
Chronic inflammation
Hormonal dysregulation
Nervous system stress
Cycle irregularity caused by underfueling
At best, some people see short-term symptom changes. At worst, symptoms rebound or intensify when weight inevitably returns (hello, weight cycling).
2. Dieting Can Worsen PCOS Symptoms
Restrictive eating can:
Increase cortisol (stress hormone)
Disrupt ovulation
Worsen insulin resistance over time
Increase fatigue, hair loss, and cycle irregularity
Fuel disordered eating patterns
Many people with PCOS are already dealing with food anxiety, body shame, or a history of dieting. Weight-loss prescriptions often add harm, not healing.
3. Weight Loss Is Not Sustainable or Predictable
Most people regain weight after intentional weight loss. This isn’t a personal failure. It’s biology.
Repeated weight cycling is associated with:
Increased insulin resistance
Higher cardiovascular risk
Greater metabolic stress
Worsened mental health outcomes
Recommending an unsustainable intervention as “treatment” is not evidence-based care.
What Actually Helps PCOS
PCOS management should focus on supporting the body, not shrinking it. Here’s what that can look like.
Nourishment, Not Restriction
Consistent, adequate nourishment helps:
Stabilize blood sugar
Support ovulation
Reduce stress hormone output
Improve energy and focus
This includes eating enough carbohydrates, protein, and fat, not eliminating food groups or “eating perfectly.”
Supporting Insulin Sensitivity Gently
For those with insulin resistance, support may include:
Regular meals and snacks
Pairing carbohydrates with protein and fat
Addressing sleep and stress
Movement that feels supportive, not punishing
Medication when appropriate
None of these require weight loss.
Nervous System Care Matters
PCOS does not exist in isolation from stress.
Chronic stress can worsen:
Cycle irregularity
Inflammation
Cravings and blood sugar swings
Hormonal symptoms
Care that supports rest, regulation, and safety in the body is part of real PCOS treatment.
Individualized Medical Support
Some people benefit from:
Hormonal contraception
Ovulation-inducing medications
Insulin-sensitizing medications
Targeted supplements (when appropriate)
These decisions should be based on symptoms and labs, not BMI.
Why Weight-Inclusive PCOS Care Is Essential
When care is weight-inclusive:
Symptoms are taken seriously at every size
Eating disorder risk is considered
Health behaviors are supported without shame
Treatment focuses on function, not appearance
Weight-inclusive care recognizes that health is not a prerequisite for care and that people deserve support regardless of body size.
If You’ve Been Told Weight Loss Is Your Only Option
If you’ve felt dismissed, blamed, or told to “come back after losing weight,” you’re not alone.
That experience reflects systemic bias in healthcare, not a lack of effort or willpower on your part.
You deserve care that:
Addresses your symptoms directly
Respects your body
Does not require shrinking yourself to be taken seriously
PCOS Care Can Be Supportive, Not Punitive
At In Good Company Nutrition, PCOS care is:
Non-diet and weight-inclusive
Focused on nourishment, not restriction
Grounded in physiology, not morality
Supportive of both physical and mental health
PCOS deserves care that supports your body rather than trying to shrink it. You can explore my approach to PCOS nutrition counseling or contact me here to see if working together feels like a good fit.
