PCOS: Doctor explains how weight loss is one of the most effective PCOS management strategies

Polycystic ovarian syndrome has taken epidemic proportions lately. The incidence of PCOS among young women in Delhi NCR is currently reported at about 17.4%, which is much higher than the national average of 8.4%.This is mainly due to urban lifestyle factors, such as poor dietary habits, obesity, stress, irregular sleep, and competitive environments.Obesity is present in around 50-70% of PCOS women, and can worsen their symptoms that are related to insulin resistance and metabolic disturbances. But the good news is that even a modest reduction in weight, about 5-10% of body weight, can lead to dramatic improvements in hormonal balance, menstrual regularity, as well as fertility.Studies show that 80% of women who successfully lost weight experienced significant relief from PCOS symptoms, especially those losing over 5% of their body weight within one year.Our latest international guidelines from ASRM and ESHRE position lifestyle interventions like adopting healthy eating behaviors and increasing physical activity the cornerstone of PCOS management. The recommendations say that lifestyle changes should be individualized, and the primary goal is not only to achieve weight loss, but to maintain healthy habits that prevent further weight gain and optimize long-term health outcomes.

Weight reduction leads to improvements in● Insulin sensitivity, lowering the risk of type 2 diabetes● Central adiposity, which is a predictor of cardiovascular risk● Lipid profiles, thereby reducing the long-term risk of heart disease● Menstrual cycles become more regular● Reduced hirsutism,● Improved ovulation and fertilityAs gynecologists we see the transformative impact of weight loss in patients everyday, but having said that, weight loss is not easy in PCOS.

There are both practical and psychological obstacles like body image issues, frustration with slow results, and unhealthy relationships with food.Weight management in PCOS needs a multi-disciplinary approach involving nutritional counseling, exercise plans, psychological support, and often medication (like insulin sensitisers- inositols, Vitamin D and Omega 3).Weight loss is 80% diet control and 20% exercise. Focus on low-glycemic and high-fiber foods.

I tell my patients to restrict anything which is sweet(including natural sources), has maida, or rice and potatoes. Choose whole grains, legumes, pulses, non-starchy vegetables, less sweet fruits like apples, chicken, fish, eggs, and nuts, which help stabilize blood sugar and curb cravings. Also calorie deficit is the key, so practice portion control, and eat slowly and avoid second helpings.Regular, 30–45 minutes of physical activity (walking, cycling, swimming, dance) most days, targeting 150 minutes/week and strength training at least twice a week boosts metabolism and insulin sensitivity without raising stress hormones.Besides this, lifestyle changes like adequate night sleep of 7–8 hours, stress-reduction by deep breathing, meditation, journaling, yoga, walking, and spending time on enjoyable activities also help promote weight management.Also, in my experience, girls who participate in group sessions or have a buddy have much higher success rates, as community and accountability play vital roles in sustaining lifestyle changes.Dr. Astha Dayal, Director Obstetrics and Gynecology, CK Birla Hospital Gurgaon, Robotic and Laparoscopic Surgeon